Bone Mineral Density Loss Eventually Stabilizes in Men With Type 1 Diabetes

Reduced bone mineral density can occur early in men with type 1 diabetes but this effect stabilizes over time, according to a study published in The Journal of Clinical Endocrinology & Metabolism. However, for women with type 1 diabetes, early reductions were not observed and their bone mineral density remained normal throughout a 10-year span.

Because previous research indicated a tendency for men with type 1 diabetes to experience bone mineral density losses, researchers conducted a longitudinal study to find out whether the declines continued. The study investigators also sought to understand the lack of bone mineral density changes in women with type 1 diabetes, as well as the temporal changes reflected in bone turnover markers.

Researchers observed 20 men and 28 women who had initially participated in their 2005-2006 study of 102 participants with type 1 diabetes in Western Australia. All previous participants were invited to take part in the 2015-2016 observational study. Researchers gave each participant a self-administered questionnaire about diabetes management and osteoporosis. The researchers also collected histories of fracture and blood and urine samples. In addition, they evaluated the results of participant physical examinations, biochemical tests related to bone metabolism, and bone mineral densitometry scans.

A review of measurements at the hip, femoral neck, lumbar spine, and distal forearm revealed a statistically significant increase in bone mineral density for men at the lumbar spine (P =.009). Researchers noticed a similar, though not significant, trend in men at the forearm. After an adjustment for the estimated glomerular filtration rate, researchers detected a significant, but weak, increase in bone mineral density at the forearm for women with type 1 diabetes (P =.046). Lastly, although researchers reviewed bone turnover markers, the changes observed paralleled those seen in studies of the general population.

Study limitations included a small sample size and self-reported information about fractures.

Researchers note that bone mineral density, “is likely to have a limited role in the context of younger individuals with type 1 diabetes.” They go further to state that their data highlight, “the need for studies of bone mineralization early in the course of type 1 diabetes in males as this seems to be when the reduction in [bone mineral density], especially at the neck of femur, occurs, perhaps as a result of the sex-specific effects of a period of insulin deficiency and poor metabolic control.”

Reference

Hamilton EJ, Drinkwater JJ, Chubb SAP, et al. A ten-year prospective study of bone mineral density and bone turnover in males and females with type 1 diabetes [published online July 18, 2018]. J Clin Endocrinol Metab. doi: 10.1210/jc.2018-00850