Systemic glucocorticoid use increases fracture risk similarly in individuals with and without type 2 diabetes: a Danish nationwide cohort study
Main finding · First MOF (hip, vertebra, humerus or forearm), after SMR weightingResult — go to the resultIncidence rate ratio 1.70 CI 1.55–1.85Authors' conclusion
We found that systemic GC use increases fracture risk to a similar degree in individuals with and individuals without T2D.
Study context
- Population
- Individuals with or without T2D receiving systemic glucocorticoid (GC) treatment between 2000 and 2018, Denmark
- Participants
- 477,605 individuals1,358,739 person-years
- Exposure
- Systemic GC treatment vs 2-year pre-treatment reference period, in individuals with vs without T2D
- T2Dn = 27,942
- Outcome
- First major osteoporotic fracture (hips, vertebrae, humerus or forearm); effect modification of GC effect by T2D status
Methodological detailswithin-subject pre-treatment reference period, standardized morbidity ratio (SMR) weighting, zero-inflated negative binomial model, Median follow-up 35 days (mean 212 days) during GC treatment and 731 days in pre-treatment period
- Within-subject pre-treatment reference period
- SMR weighting
- Zero-inflated negative binomial model
- Median follow-up 35 days (mean 212 days) during GC treatment and 731 days in pre-treatment period
Main finding
As reported in the abstract
First MOF (hip, vertebra, humerus or forearm), after SMR weighting
Incidence rate ratio
1.70
CI 1.55–1.85
GC treatmentvs Pre-treatment reference
IRR 1.70 (CI 1.55–1.85)
Observational data: associations, not effects.
Further findings
Subgroup and sensitivity analyses (sex, age < 65, 6574, ≥ 75 years; recurring fractures; time-since-initiation; dosage; alternative models)
- Results similar across subgroup and sensitivity analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Systemic glucocorticoid use increases fracture risk similarly in individuals with and without type 2 diabetes: a Danish nationwide cohort study. Osteoporos Int. Published 11 September 2026. doi:10.
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