Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis

Objective Diabetes mellitus (DM) is associated with an increased fracture risk; however, the impact of DM and subsequent fracture at different sites and the associations according to patient characteristics remain unknown. Design Meta-analysis Data sources The PubMed, EMBASE and Cochrane Library databases were searched from inception to March 2018. Eligibility criteria We included prospective and retrospective cohort studies on the associations of DM and subsequent fracture risk at different sites. Data extraction and synthesis Two authors independently extracted data and assessed the study quality. Relative risks (RRs) with 95% CIs were calculated using a random-effects model, and the heterogeneity across the included studies was evaluated using I 2 and Q statistics. Results Overall, DM was associated with an increased risk of total (RR: 1.32; 95% CI 1.17 to 1.48; p Conclusions Patients with DM had greater risks of total, hip, upper arm and ankle fractures, with T1DM having a more harmful effect than T2DM.