Patients with type 1 diabetes (T1D) are at higher risk of femoral fractures, particularly subtrochanteric or femoral shaft fractures, compared to type 2 diabetes patients and those without diabetes, according to a Danish study published May 27, 2026, in the journal Diabetes Care (1).

This study examined the impact of diabetes, TID or T2D, on the incidence and pattern of femoral fractures in adults aged 65 years and older. It sought to determine if  type 1 diabetes (T1D) and type 2 diabetes (T2D) were associated with an increased risk of subtrochanteric/femoral shaft (ST/FS) fractures and hip fractures, and whether diabetes influenced susceptibility to specific fracture locations. Utilizing data from Danish national health registries from 1997 to 2021, researchers evaluated 204,096 femoral fractures. Out of the total fractures included in the study, 33,939 (16.6%) were ST or FS fractures and 170,157 (83.4%) were hip fractures.

Analysis showed that both T1D and T2D were associated with higher incidence of femoral fractures compared to participants without diabetes. T1D was associated with a significantly increased incidence of both ST/FS fractures (IRR 2.53) and hip fractures (IRR 2.17), whereas T2D showed comparatively modest increases (IRR 1.08 and 1.06, respectively). But after adjusting for age, the association between diabetes and high fracture risk remained significant only for T1D.

Among patients with femoral fractures, both T1D and T2D were associated with a greater likelihood of ST/FS fractures vs hip fractures, with OR of 1.14 for T1D and 1.05 for T2D.

These findings show that T1D is an important risk factor for femoral fractures and may increase susceptibility to ST/FS fractures. Hence, careful assessment and monitoring of bone health are recommended for individuals with T1D, particularly in older age groups.

Reference

1.      Bech AA, et al. Diabetes and femoral fracture patterns: a nationwide registry study (1997-2021). Diabetes Care. 2026 May 27:dc252899. doi: 10.2337/dc25-2899.