An A1C level (a measure of glucose control over the previous 2–3 months) of at least 7.9% and a longer length of time living with type 1 diabetes are risk factors for bone fractures, according to a new study in the journal Bone.
Researchers from Italy looked at data from 600 adults with type 1 diabetes who had no history of conditions that would cause osteoporosis or use of medicines that would affect bone metabolism. Incidence of fractures was determined using medical records and questionnaires. Over the course of five years, 18.5% (111) of the study participants sustained at least one fracture, with 29 of those patients reporting at least two fractures.
The investigators found that those with an A1C level of 7.9% or higher were 3.5 times more likely to experience multiple fractures compared to those with an A1C of less than 7.2%. Additionally, those who had lived with type 1 diabetes for more 26 years were 7.5 times more likely to sustain multiple fractures than those who’d had the condition for fewer than 14 years.
“To our knowledge, this is the first study assessing fracture risk factors in a subpopulation of multi-fractured [type 1 diabetes] patients,” the study authors note. “This allowed us to show that poor glycemic control over the previous 5 years and long disease duration are associated with increased risk of multiple fractures. Although an association between poor glycemic control and increased fracture risk has been reported for individuals with [type 2 diabetes], the evidence on glycemic control and fracture risk in [type 1 diabetes] is less consistent.”
Steps to prevent fragile bones should be shared with those living with type 1 diabetes, the researchers recommend.