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Impact of glycaemic control on fracture risk in 5368 people with newly diagnosed Type 1 diabetes: a time‐dependent analysis
Author(s) -
Thayakaran R.,
Perrins M.,
Gokhale K. M.,
Kumaran S.,
Narendran P.,
Price M. J.,
Nirantharakumar K.,
Toulis K. A.
Publication year - 2019
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13945
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , fracture (geology) , endocrinology , geotechnical engineering , engineering
Aims To assess whether glycaemic control is associated with a lifelong increased risk of fracture in people with newly diagnosed Type 1 diabetes. Methods People with newly diagnosed Type 1 diabetes between 1 January 1995 and 10 May 2016 were identified in The Health Improvement Network database. Longitudinal HbA 1c measurements from diagnosis to fracture or study end or loss to follow‐up were collected. A Cox proportional hazards model with HbA 1c included as a time‐dependent variable was fitted to these data. Results Some 5368 people with newly diagnosed Type 1 diabetes were included. The estimated adjusted hazard ratio ( aHR ) for HbA 1c was statistically significant [ aHR 1.007; 95% confidence interval ( CI ) 1.002–1.011 (mmol/mol) and aHR 1.07; 95% CI 1.03–1.12 (%)]. An incremental higher risk of fracture was observed with increasing levels of HbA 1c . Conclusions In people with newly diagnosed Type 1 diabetes, higher HbA 1c is associated with an increased risk for fractures.