People with type 1 diabetes who have well-controlled blood glucose levels are less likely to experience bone fractures, research suggests.
It was already known that diabetes is associated with an increased risk of fractures, but the impact of poor or good glycemic control on fracture risk has not been fully understood.
The Swiss trial conducted by researchers at the University of Basel involved 3,329 people with type 1 diabetes and 44,275 who had type 2 diabetes.
They tracked their HbA1c levels across three years. The research team took an average nine measurements from the type 1 group and 11 from those with type 2 diabetes.
The National Institute for Health and Care Excellence (NICE) recommends that adults with type 1 diabetes aim for HbA1c levels of 48 mmol/mol (6.5%).
Overall, both type 1 diabetes and type 2 diabetes were associated with an increased risk of factors.
Those with type 1 diabetes who had average HbA1c levels of greater than 64 mmol/mol (8.0%) were linked with having an increased fracture risk compared to those with an average HbA1c of 53 mmol/mol (7.0%) or less. This association was not present in those with type 2 diabetes.
The researchers hypothesised that the risk fracture in people with type 2 diabetes is likely related to other diabetes-related comorbidities, rather than HbA1c.
One of the trial’s author Sarah Charlier, from the University Hospital Basel, said: “Nevertheless, fracture risk in type 2 diabetes is of clinical relevance as well as it is a major health concern worldwide due to its high prevalence.”
The findings have been published in the Endocrine Society’s Journal of Clinical Endocrinology &Metabolism.
