What Leads to Decreased Bone Density in People with Type 1 Diabetes?

Young girl having her blood sugar tested with a glucometerResearch has shown that adults with type 1 diabetes have reduced bone mineral density (BMD) and an increased risk of fracture, but it’s not yet known what causes this. To investigate this more deeply, US researchers looked at adolescents with type 1 diabetes.

They hypothesized that early detection of derangements in bone markers in adolescents can provide insight into what causes bone disease in people who have type 1 diabetes.

Researchers evaluated adolescents with type 1 diabetes and the relationships between:

  • BMD
  • bone anabolic and turnover markers
  • metabolic control

They published their findings in the article “Metabolic control and bone health in adolescents with type 1 diabetes,” which appeared in the October 2011 issue of the International Journal of Pediatric Endocrinology.

This cross-sectional study included 57 adolescents who had type 1 diabetes and who also had A1c levels that were consistently ≥9% (poor control [PC]: n=27) or <9% (favorable control [FC]: n=30) for 2 years before they enrolled in the study.

In addition, study participants had type 1 diabetes for at least 3 years. They did not have diabetes complications, celiac disease, or other chronic diseases.

Researchers did not note any differences between the A1c groups in regards to:

  • BMD
  • components of the insulin-like growth factor system
  • 25-hydroxyvitamin D status

They found that the prevalence of 25-hydroxyvitamin D abnormalities in adolescents with type 1 diabetes was similar to that seen in the general adolescent population.

Few of the study participants met the recommended dietary allowance for both vitamin D and calcium.

At the end of the study, the research team indicated that these data do not provide evidence of association between the degree of metabolic control and BMD in adolescents who have type 1 diabetes. Furthermore, adolescents who have type 1 diabetes also have a high prevalence of serum 25-hydroxyvitamin D abnormalities. Longitudinal studies are necessary to further evaluate the predictive value of vitamin D abnormalities on risk of bone fracture.

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