Fracture Risk and Postoperative Outcomes in Type 1 Diabetes Pediatric Patients: Identifying High-Risk Patients
Presenter Status
Medical Student
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Dr. Aaron Shaw
Presentation Type
Poster
Start Date
19-5-2026 12:00 PM
End Date
19-5-2026 1:00 PM
Abstract Text
Background: Type 1 diabetes mellitus (T1DM) is commonly diagnosed during childhood and adolescence, a critical period for skeletal development. T1DM patients have been shown to have insulin deficiency, chronic hyperglycemia, and inflammatory changes that are suspected to disrupt bone metabolism and accrual. However, whether these effects are clinically meaningful for orthopedic outcomes such as fracture risk and postoperative complications in patients with T1DM remains undetermined.
Objective: This review summarizes current evidence on fracture risk and orthopedic surgical outcomes in children and adolescents with T1D and proposes a clinically relevant framework for risk stratification.
Methods: A narrative literature review was conducted using PubMed to identify pediatric and translational studies evaluating bone density, fracture risk, and orthopedic operative outcomes in T1D. Articles were selected based on clinical relevance to pediatric orthopedic practice.
Results: Evidence regarding fracture risk in youth T1DM is mixed. Cross-sectional studies demonstrate modest reductions in bone mineral density (BMD), while studies on fracture risk lose significance after adjustment for confounders such as medication use, hypoglycemia, falls, and comorbidities. In contrast, a large, population-based cohort study found a progressive risk of fractures over time, especially of the lower extremity, that began in childhood. For postoperative outcomes, studies comparing T1DM to non-diabetic controls reveal that overall complication and reoperation rates may appear similar. However, patients with T1DM experience higher unplanned readmissions and prolonged hospitalizations. Further stratification of risk factors suggests that insulin requirements, glycemic control, age at diagnosis, BMI, and the presence of diabetic complications influence skeletal outcomes.
Conclusion: Pediatric patients with T1DM indicate possible cumulative skeletal vulnerability that may predispose them to fractures and postoperative complications over time. Early identification of these high-risk individuals through targeted monitoring and treatment plans may improve orthopedic outcomes and guide perioperative care, though further studies are needed to refine risk-stratification strategies.
Fracture Risk and Postoperative Outcomes in Type 1 Diabetes Pediatric Patients: Identifying High-Risk Patients
Background: Type 1 diabetes mellitus (T1DM) is commonly diagnosed during childhood and adolescence, a critical period for skeletal development. T1DM patients have been shown to have insulin deficiency, chronic hyperglycemia, and inflammatory changes that are suspected to disrupt bone metabolism and accrual. However, whether these effects are clinically meaningful for orthopedic outcomes such as fracture risk and postoperative complications in patients with T1DM remains undetermined.
Objective: This review summarizes current evidence on fracture risk and orthopedic surgical outcomes in children and adolescents with T1D and proposes a clinically relevant framework for risk stratification.
Methods: A narrative literature review was conducted using PubMed to identify pediatric and translational studies evaluating bone density, fracture risk, and orthopedic operative outcomes in T1D. Articles were selected based on clinical relevance to pediatric orthopedic practice.
Results: Evidence regarding fracture risk in youth T1DM is mixed. Cross-sectional studies demonstrate modest reductions in bone mineral density (BMD), while studies on fracture risk lose significance after adjustment for confounders such as medication use, hypoglycemia, falls, and comorbidities. In contrast, a large, population-based cohort study found a progressive risk of fractures over time, especially of the lower extremity, that began in childhood. For postoperative outcomes, studies comparing T1DM to non-diabetic controls reveal that overall complication and reoperation rates may appear similar. However, patients with T1DM experience higher unplanned readmissions and prolonged hospitalizations. Further stratification of risk factors suggests that insulin requirements, glycemic control, age at diagnosis, BMI, and the presence of diabetic complications influence skeletal outcomes.
Conclusion: Pediatric patients with T1DM indicate possible cumulative skeletal vulnerability that may predispose them to fractures and postoperative complications over time. Early identification of these high-risk individuals through targeted monitoring and treatment plans may improve orthopedic outcomes and guide perioperative care, though further studies are needed to refine risk-stratification strategies.
Comments
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Poster Board Number: 8