TYPE 2 diabetes is tied to a greater risk of fractures, particularly of the hip, ankle, and foot, a 2026 meta-analysis of more than 13 million participants has found.
Women with Type 2 diabetes had a significantly higher fracture risk than men.
Type 2 Diabetes and Calcium Metabolism
The global prevalence of Type 2 diabetes continues to increase, with it accounting for approximately 96% of all cases of diabetes mellitus. It is the ninth leading cause of death, with over 1 million deaths annually worldwide, and the seventh leading cause of disability.
Having Type 2 diabetes affects a person’s calcium metabolism, bone turnover rates, and bone mineral density. It has been suggested that these factors may together contribute to an increased risk of factors in individuals with Type 2 diabetes.
However, previous large-scale studies have been limited to a small number of skeletal sites. Researchers offered a comprehensive assessment of more than 20 anatomical sites.
Elevated Fracture Risk
Researchers analysed 22 studies, assessing a total of more than 13 million people. Across all anatomical areas, people with Type 2 diabetes have a 25% increased risk of fractures compared to individuals without Type 2 diabetes, researchers reported.
People with Type 2 diabetes are at a particularly higher risk of lower limb fractures: more than 40%. In other areas of the body, they were consistently at a greater risk of fracture, at 30% increased risk for upper limb fractures and 14% higher risk for fragility fractures.
Women and those who have had Type 2 diabetes for a longer duration experience stronger ties between Type 2 diabetes and fracture risk, particularly for lower limb fractures, analyses found.
Targeted Fracture Prevention
The established association between Type 2 diabetes and fracture risk highlights the importance of targeted and personalised fracture prevention strategies, as well as site-specific risk assessment, researchers reported.
They also emphasised that future primary studies should explore how ethnicity influences fracture risk in the given context.
References
Naderpour S et al. Association between type 2 diabetes and site-specific fracture risk: A systematic review and meta-analysis of cohort studies including over 13 million participants. 2026;DOI:10.1111/dme.70276.
International Diabetes Federation. The diabetes atlas. 2025. Available at: https://diabetesatlas.org/. Last accessed: 17 March 2026.
Abdul Basith Khan M et al. Epidemiology of type 2 diabetes – global burden of disease and forecasted trends. J Epidemiol Glob Health. 2020;10(1):107-111.
McNair P et al. Bone mineral loss in insulin-treated diabetes mellitus: studies on pathogenesis. Acta Endocrinol. 1979;90(3):463-472.
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