Fractures in children and adolescents with diabetes mellitus during 2001-2020

Purpose: To compare fracture risk among paediatric patients, between those with diabetes mellitus (DM) and a matched comparison group. Methods: In this registry-based cohort study, individuals who were diagnosed with DM during 2001-2020, at age 1-17 years, were matched in a 1:5 ratio to a comparison group. Clinical, laboratory and demographic data were obtained from the electronic database of Meuhedet Health Services. Results: The DM and comparison groups included 1049 and 5245 individuals, respectively. The median age at DM diagnosis was 10.9 years. The median follow-up period of both groups was 5.5 years (IQR 3.6-8.2). We did not find a statistically significant risk for fractures among children with DM (adjusted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.93-1.31, p=0.25). In a subgroup analysis of boys aged >11 years at DM diagnosis, the adjusted HR for fractures was 1.47 (95%CI 1.06-2.04, p=0.02) relative to the comparison group. In a multivariate analysis, male gender (adjusted HR 1.99, 95%CI 1.46-2.73, p<0.001) and recurrent hospitalizations (adjusted HR 1.53 95%CI 1.02-2.30, p=0.04) were associated with increased risks for fractures among children with DM. Conclusions : We found increased fracture risk among boys aged >11 years at diagnosis of DM compared to a matched comparison group.