Global and regional estimates of hip fracture burden associated with type 1 diabetes from 1990 to 2021

Diabetes Obes Metab. 2024 Dec;26(12):5960-5970. doi: 10.1111/dom.15970. Epub 2024 Sep 26.

Abstract

Aim: To assess the global and regional burden of hip fractures associated with type 1 diabetes (T1D) from 1990 to 2021.

Materials and methods: The population attributable fraction was calculated by combining the published risk ratio with T1D prevalence (age ≥ 20 years) from the Global Burden of Disease study to estimate the T1D-associated hip-fracture burden. Trends were assessed using the age-standardized incidence rate (ASIR) and estimated annual percentage change (EAPC).

Results: The global incidence of T1D-related hip fractures was 290 180 in 2021 with an ASIR of 3.96 (95% confidence interval: 1.92-5.87) per 100 000 population and a male-to-female ratio of 0.54. At the super-regional level, the highest incidence (204 610) and ASIR (13.09 per 100 000 population; 6.40-25.53) were observed in high-income regions, in particular in Australasia and Western Europe. Notably, Australasia exhibited the highest EAPC, 2.90% in T1D-associated ASIR, followed by East Asia (2.73%). The incidence among those aged 45-64 years grew significantly in 14 regions over the past decade. Nationally, the ASIR increased in 166 countries from 1990 to 2021.

Conclusions: High-income regions experienced the greatest burden of T1D-associated hip fracture, while Australasia and East Asia witnessed the largest increase over the last 32 years. Prioritizing the promotion of T1D treatment and hip-fracture screening for middle-aged females living with T1D is crucial in these regions.

Keywords: disease burden; hip fracture; population attributable fraction; type 1 diabetes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asia, Eastern / epidemiology
  • Australasia / epidemiology
  • Cost of Illness
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Europe / epidemiology
  • Female
  • Global Burden of Disease*
  • Global Health* / statistics & numerical data
  • Hip Fractures* / epidemiology
  • Hip Fractures* / etiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Young Adult