Type 1 diabetes link to bone loss

From AustralianDoctor.com.au // Sept. 21, 2005
By Jill Stein

ALMOST half of adults with type 1 diabetes have low bone mineral density, according to a study reported at the European Association for the Study of Diabetes meeting held in Athens last week.

Rheumatologist Dr Heather McDonald-Blumer and colleagues from the University of Toronto in Canada presented results of a bone mineral density (BMD) assessment in adult type 1 diabetes patients from a large community diabetes practice.

Among 130 people who completed a BMD assessment, 40% had a T score of less than -1.0 in at least one of three measured sites (femoral neck, total hip and lumbar spine).

"In other words, their T scores were in the low bone mass or osteoporotic range," Dr McDonald-Blumer said.

Men were affected more than women, with 46% of male type 1 diabetic patients showing low BMD compared with 34% of women, a trend especially apparent in the quartile with the lowest BMD.

"Overall, a disproportionate number of young male patients had low BMD scores," Dr McDonald-Blumer said.

While low BMD was more common in older age groups, it was also high among younger patients (11 of 30 patients aged 20-34).

In this population, BMD values did not correlate directly with age, BMI, age of onset of diabetes, duration of diabetes, the presence of micro- or macrovascular complications or the presence of traditional osteoporosis risk factors, Dr McDonald-Blumer said.

She said the results suggested undefined mechanisms were likely to be responsible for low bone mass in this population and further research was needed in the broader type 1 diabetic population.

Patients who were pregnant, seeking pregnancy or who had secondary causes of osteoporosis, or those with low BMD using anti-resorptive medications, were excluded from the study.