Type 1 Diabetes Mellitus Impact on Bone Mineral Density

The role of diabetic impact index [HbAlc (whole) x diabetes duration] on bone mineral density changes in patients with type 1 diabetes mellitus was studied. Methods: In this case-control study we analyzed bone mineral density measured at the forearm, lumber spine and hip using dual energy X-ray absorptiometry in 60 patients with type 1 diabetes mellitus. Patients were followed-up in type 1 diabetes mellitus in Clinic-Diabetes and Endocrinology Center-AlNoor Specialist Hospital, Holly Makkah, KSA. Findings for them were compared with those from normal age- and sex-matched control subjects from the local community. HbA lc, serum calcium, phosphorus and magnesium were measured. Diabetic impact index [HbAlc (whole) x diabetes duration] were calculated in diabetic patients. Results: Type 1 diabetes mellitus patients were associated with a lower bone mineral density at forearm/wrist (p=0.001), lumber spine (p=0.001) and total hip (p=0.000) versus control subjects and the lower results for bone mineral density was found in patients with proteinurea. Osteopenia was present in 32%, and osteoporosis in 23%. Furthermore the duration of diabetes (r=-0.794 at the forearm/wrist, r=-0.879 at the lumbar spine, and r=-0.817 at the total hip) and glycemic control (r=- 0.662 at the forearm, r=-0.712 at the lumber spine, and r=-0.693 at the total hip) seems to play a key role given the lower bone mineral density found among patients with type 1 diabetes mellitus. Conclusion: Patients with type 1 diabetes may be at increased risk of osteopenia and osteoporosis. HbA lc (whole) and diabetes duration are the most important determinant of bone mineral density.