ECE2016 Guided Posters Diabetes (1) (10 abstracts)
Introduction: Type 1 diabetes mellitus (T1DM) is associated with reduced bone mineral density (BMD) and increased bone turnover. However, data regarding the influence of glycemic control on bone are limited. The aim of this study was to evaluate BMD and bone remodeling markers in patients with T1DM in relation to changes in glycemic control.
Methods/design: We studied 107 patients with T1DM (Group-D) (mean age: 34+8.1 years, M/F: 48/59) and 95 healthy controls (Group-C) matched for age, sex and BMI. Patients in Group-D were re-examined after one-year (FU). In both groups, we measured glycated hemoglobin (HbA1c), BMD at lumbar spine (LS) and femoral neck (FN) by dual energy X-ray absorptiometry. Bone resorption was assessed by β-crosslaps and bone formation was assessed by serum levels of type 1 procollagen total N-terminal propeptide (TP1NP). Currently, fifty patients from Group-D completed the FU and repeated the measurements as baseline. Based on the current literature, BMD changes at LS more than 3% and at FN more than 6% are considered to be significant.
Results: In Group-D, mean duration of diabetes was 15.1+7.4 years and mean HbA1c was 8.2+1.3%. In Group-D, BMD (g/cm2) and T-score were lower at LS and FN compared to Group-C (LS: 1.024±0.201 vs 1.052±0.143. P=0.04, −0.3±1.6 vs 0.9±1.7, P=0.02) (FN: 0.696±0.121 vs 0.898±0.112, P=0.042, −0.1+1.5 vs 1.4±1.0, P=0.038). No significant difference in β-crosslaps and TP1NP was observed between the two groups. At FU in Group-D, 36/50 patients had >0.5% reduction in HbA1c (Group-DR), 8/50 had about the same HbA1c (+0.4%)(Group-DS) and 6/50 had >0.5% increase in HbA1c (Group-DI). At FU, Group-DR had 3.3% increase in BMD at LS and 5.6% at FN and TP1NP was significantly higher compared to baseline (P=0.043).
Conclusion: T1DM is associated with reduced BMD but improvement of glycemic control appears to ameliorate BMD and bone turnover.