Impact of glycaemic control on fracture risk in 5368 people with newly diagnosed Type 1 diabetes: a time-dependent analysis

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.