Endocrine Abstracts

Introduction: Hyperglycemia in type 1 diabetes mellitus (T1DM) is an important determinant of bone health. However, data on the effect of glycemic changes on bone metabolism are limited. The aim of this study was to evaluate BMD in patients with T1DM in relation to changes of glycemic control.

Methods/Design: We studied 118 uncomplicated patients with T1DM (GroupD) (mean age: 30.12+8.78years, F/M: 65/53) and 94 healthy controls (GroupC) matched for age, sex and body mass index (BMI). All patients in GroupD were re-examined after 18 months (FU). In both groups, we measured HbA1c and BMD at lumbar spine (LS), total hip (TH) and femoral neck (FN) by dual energy X-ray absorptiometry (DXA). HbA1c changes of ≥ 0.5% were considered significant. For BMD changes to be considered significant a minimum change of 3% at LS, 3.3% at TH and 4.7% at FN is needed.

Results: At baseline, in GroupD mean duration of diabetes was 16.16+9.56 years, mean HbA1c was 7.94+1.37% and absolute values of BMD (g/m²) were significantly lower at LS, TH and FN compared to GroupC (P=0.018, P<0.001 and P=0.007, respectively). At FU, in GroupD mean HbA1c was 7.93+1.59% and BMD changes from the baseline were: at LS: -1.4%, TH: -1% and FN: -2.0%. In FU, males in GroupD appeared to have greater decreases in BMD than females (M: LS: -2.2%, TH: -3.3% and FN: -4.1%. vs F: LS: -0.8%, TH: -0.9% and FN: -0.8%). There was a significant negative correlation between HbA1c changes and TH BMD changes (r=-0.233, P=0.02).

Conclusion: Worsening glycemic control is associated with reduction in BMD in patients T1DM, and it seems that males are more affected than females.