Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study

Jakob Starup-Linde; Julie Støy; Pernille Bundgaard Grinderslev; Bente Langdahl; Torben Harsløf

doi:10.1007/s00198-025-07443-y

Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study

Jakob Starup-Linde^*, Julie Støy, Pernille Bundgaard Grinderslev, Bente Langdahl, Torben Harsløf

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Summary: The prevalence of osteoporosis in individuals with type 1 diabetes (T1D) was investigated. Based on IOF/ADA recommendations, 36% had indications for anti-osteoporotic therapy. We propose that postmenopausal women and men with T1D and age > 50 years are screened for osteoporosis. Purpose: Type 1 diabetes is associated with an increased fracture risk and a lowering of the threshold for osteoporosis treatment has been recommended to be increased from a bone mineral density of a T-score ≤ − 2.5 to a T-score ≤ − 2.0. In this study, we aimed to investigate the prevalence and risk factors for osteoporosis in type 1 diabetes using the classic diagnostic criteria defined by WHO and the novel T-score cutoff of − 2.0 proposed by the ADA. Methods: In a cross-sectional study, data were collected from the type 1 diabetes clinic at Steno Diabetes Center Aarhus, Aarhus University Hospital, where active attenders in the clinic were offered screening for osteoporosis using DXA of the lumbar spine and hip in the time period 2020–2022. Results: A total of 764 individuals with type 1 diabetes had a DXA and of these, 25.5% had osteoporosis based on a vertebral fracture or T-score ≤ − 2.5, and 36% met ADA-treatment criteria with a vertebral fracture or T-score ≤ − 2.0. In multivariate analysis increasing age (OR = 1.3, 95% CI 1.0; 1.7) and a family history of osteoporosis (OR = 1.9, 95% CI 1.2; 3.0) were associated with an increased risk of osteoporosis, whereas an increase in BMI was associated with a decreased risk of osteoporosis (OR = 0.87, 95% CI 0.82; 0.92). Conclusion: The present study finds that a high proportion of individuals with type 1 diabetes have osteoporosis, and an even higher proportion meet the treatment criteria proposed by the ADA, and thus, early detection and treatment of osteoporosis may reduce the apparent increased fracture risk in type 1 diabetes.

Originalsprog	Engelsk
Artikelnummer	107324
Tidsskrift	Osteoporosis International
Vol/bind	36
Nummer	5
Sider (fra-til)	823-831
Antal sider	9
ISSN	0937-941X
DOI	https://doi.org/10.1007/s00198-025-07443-y
Status	Udgivet - maj 2025

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10.1007/s00198-025-07443-y

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title = "Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study",

abstract = "Summary: The prevalence of osteoporosis in individuals with type 1 diabetes (T1D) was investigated. Based on IOF/ADA recommendations, 36% had indications for anti-osteoporotic therapy. We propose that postmenopausal women and men with T1D and age > 50 years are screened for osteoporosis. Purpose: Type 1 diabetes is associated with an increased fracture risk and a lowering of the threshold for osteoporosis treatment has been recommended to be increased from a bone mineral density of a T-score ≤ − 2.5 to a T-score ≤ − 2.0. In this study, we aimed to investigate the prevalence and risk factors for osteoporosis in type 1 diabetes using the classic diagnostic criteria defined by WHO and the novel T-score cutoff of − 2.0 proposed by the ADA. Methods: In a cross-sectional study, data were collected from the type 1 diabetes clinic at Steno Diabetes Center Aarhus, Aarhus University Hospital, where active attenders in the clinic were offered screening for osteoporosis using DXA of the lumbar spine and hip in the time period 2020–2022. Results: A total of 764 individuals with type 1 diabetes had a DXA and of these, 25.5% had osteoporosis based on a vertebral fracture or T-score ≤ − 2.5, and 36% met ADA-treatment criteria with a vertebral fracture or T-score ≤ − 2.0. In multivariate analysis increasing age (OR = 1.3, 95% CI 1.0; 1.7) and a family history of osteoporosis (OR = 1.9, 95% CI 1.2; 3.0) were associated with an increased risk of osteoporosis, whereas an increase in BMI was associated with a decreased risk of osteoporosis (OR = 0.87, 95% CI 0.82; 0.92). Conclusion: The present study finds that a high proportion of individuals with type 1 diabetes have osteoporosis, and an even higher proportion meet the treatment criteria proposed by the ADA, and thus, early detection and treatment of osteoporosis may reduce the apparent increased fracture risk in type 1 diabetes.",

keywords = "Anti-osteoporotic treatment, Bone mineral density, Compliance, Osteoporosis, Type 1 diabetes",

author = "Jakob Starup-Linde and Julie St{\o}y and Grinderslev, {Pernille Bundgaard} and Bente Langdahl and Torben Harsl{\o}f",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2025.",

year = "2025",

month = may,

doi = "10.1007/s00198-025-07443-y",

language = "English",

volume = "36",

pages = "823--831",

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Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study. / Starup-Linde, Jakob; Støy, Julie; Grinderslev, Pernille Bundgaard et al.
I: Osteoporosis International, Bind 36, Nr. 5, 107324, 05.2025, s. 823-831.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study

AU - Starup-Linde, Jakob

AU - Støy, Julie

AU - Grinderslev, Pernille Bundgaard

AU - Langdahl, Bente

AU - Harsløf, Torben

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/5

Y1 - 2025/5

N2 - Summary: The prevalence of osteoporosis in individuals with type 1 diabetes (T1D) was investigated. Based on IOF/ADA recommendations, 36% had indications for anti-osteoporotic therapy. We propose that postmenopausal women and men with T1D and age > 50 years are screened for osteoporosis. Purpose: Type 1 diabetes is associated with an increased fracture risk and a lowering of the threshold for osteoporosis treatment has been recommended to be increased from a bone mineral density of a T-score ≤ − 2.5 to a T-score ≤ − 2.0. In this study, we aimed to investigate the prevalence and risk factors for osteoporosis in type 1 diabetes using the classic diagnostic criteria defined by WHO and the novel T-score cutoff of − 2.0 proposed by the ADA. Methods: In a cross-sectional study, data were collected from the type 1 diabetes clinic at Steno Diabetes Center Aarhus, Aarhus University Hospital, where active attenders in the clinic were offered screening for osteoporosis using DXA of the lumbar spine and hip in the time period 2020–2022. Results: A total of 764 individuals with type 1 diabetes had a DXA and of these, 25.5% had osteoporosis based on a vertebral fracture or T-score ≤ − 2.5, and 36% met ADA-treatment criteria with a vertebral fracture or T-score ≤ − 2.0. In multivariate analysis increasing age (OR = 1.3, 95% CI 1.0; 1.7) and a family history of osteoporosis (OR = 1.9, 95% CI 1.2; 3.0) were associated with an increased risk of osteoporosis, whereas an increase in BMI was associated with a decreased risk of osteoporosis (OR = 0.87, 95% CI 0.82; 0.92). Conclusion: The present study finds that a high proportion of individuals with type 1 diabetes have osteoporosis, and an even higher proportion meet the treatment criteria proposed by the ADA, and thus, early detection and treatment of osteoporosis may reduce the apparent increased fracture risk in type 1 diabetes.

AB - Summary: The prevalence of osteoporosis in individuals with type 1 diabetes (T1D) was investigated. Based on IOF/ADA recommendations, 36% had indications for anti-osteoporotic therapy. We propose that postmenopausal women and men with T1D and age > 50 years are screened for osteoporosis. Purpose: Type 1 diabetes is associated with an increased fracture risk and a lowering of the threshold for osteoporosis treatment has been recommended to be increased from a bone mineral density of a T-score ≤ − 2.5 to a T-score ≤ − 2.0. In this study, we aimed to investigate the prevalence and risk factors for osteoporosis in type 1 diabetes using the classic diagnostic criteria defined by WHO and the novel T-score cutoff of − 2.0 proposed by the ADA. Methods: In a cross-sectional study, data were collected from the type 1 diabetes clinic at Steno Diabetes Center Aarhus, Aarhus University Hospital, where active attenders in the clinic were offered screening for osteoporosis using DXA of the lumbar spine and hip in the time period 2020–2022. Results: A total of 764 individuals with type 1 diabetes had a DXA and of these, 25.5% had osteoporosis based on a vertebral fracture or T-score ≤ − 2.5, and 36% met ADA-treatment criteria with a vertebral fracture or T-score ≤ − 2.0. In multivariate analysis increasing age (OR = 1.3, 95% CI 1.0; 1.7) and a family history of osteoporosis (OR = 1.9, 95% CI 1.2; 3.0) were associated with an increased risk of osteoporosis, whereas an increase in BMI was associated with a decreased risk of osteoporosis (OR = 0.87, 95% CI 0.82; 0.92). Conclusion: The present study finds that a high proportion of individuals with type 1 diabetes have osteoporosis, and an even higher proportion meet the treatment criteria proposed by the ADA, and thus, early detection and treatment of osteoporosis may reduce the apparent increased fracture risk in type 1 diabetes.

KW - Anti-osteoporotic treatment

KW - Bone mineral density

KW - Compliance

KW - Osteoporosis

KW - Type 1 diabetes

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U2 - 10.1007/s00198-025-07443-y

DO - 10.1007/s00198-025-07443-y

M3 - Journal article

C2 - 40100348

AN - SCOPUS:105000224775

SN - 0937-941X

VL - 36

SP - 823

EP - 831

JO - Osteoporosis International

JF - Osteoporosis International

IS - 5

M1 - 107324

ER -

Prevalence and risk factors for osteoporosis in type 1 diabetes—results from an observational study

Abstract

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