{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:29:10Z","timestamp":1792052950343,"version":"4.4.0"},"reference-count":39,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T00:00:00Z","timestamp":1459468800000},"content-version":"vor","delay-in-days":249,"URL":"http:\/\/www.diabetesjournals.org\/site\/license"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["HD-068373"],"award-info":[{"award-number":["HD-068373"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K12-DK-094723"],"award-info":[{"award-number":["K12-DK-094723"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24-DK-076808"],"award-info":[{"award-number":["K24-DK-076808"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23-DK-093556"],"award-info":[{"award-number":["K23-DK-093556"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>This study was conducted to determine if type 1 diabetes is associated with an increased risk of fracture across the life span.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This population-based cohort study used data from The Health Improvement Network (THIN) in the U.K. (data from 1994 to 2012), in which 30,394 participants aged 0\u201389 years with type 1 diabetes were compared with 303,872 randomly selected age-, sex-, and practice-matched participants without diabetes. Cox regression analysis was used to determine hazard ratios (HRs) for incident fracture in participants with type 1 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 334,266 participants, median age 34 years, were monitored for 1.9 million person-years. HR were lowest in males and females age &amp;lt;20 years, with HR 1.14 (95% CI 1.01\u20131.29) and 1.35 (95% CI 1.12\u20131.63), respectively. Risk was highest in men 60\u201369 years (HR 2.18 [95% CI 1.79\u20132.65]), and in women 40\u201349 years (HR 2.03 [95% CI 1.73\u20132.39]). Lower extremity fractures comprised a higher proportion of incident fractures in participants with versus those without type 1 diabetes (31.1% vs. 25.1% in males, 39.3% vs. 32% in females; P &amp;lt; 0.001). Secondary analyses for incident hip fractures identified the highest HR of 5.64 (95% CI 3.55\u20138.97) in men 60\u201369 years and the highest HR of 5.63 (95% CI 2.25\u201314.11) in women 30\u201339 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Type 1 diabetes was associated with increased risk of incident fracture that began in childhood and extended across the life span. Participants with type 1 diabetes sustained a disproportionately greater number of lower extremity fractures. These findings have important public health implications, given the increasing prevalence of type 1 diabetes and the morbidity and mortality associated with hip fractures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc15-0783","type":"journal-article","created":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T01:01:48Z","timestamp":1438045308000},"page":"1913-1920","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":253,"title":["Type 1 Diabetes Is Associated With an Increased Risk of Fracture Across the Life Span: A Population-Based Cohort Study Using The Health Improvement Network (THIN)"],"prefix":"10.2337","volume":"38","author":[{"given":"David R.","family":"Weber","sequence":"first","affiliation":[{"name":"Golisano Children\u2019s Hospital, University of Rochester School of Medicine and Dentistry, Rochester, 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