Despite normal growth and maturation, adolescents with type 1 diabetes appear to have reduced bone mass and bone size.
Dr. Laurie J. Moyer-Mileur of the University of Utah, Salt Lake City and colleagues note that, recent observations "suggest that children and adolescents with type 1 diabetes mellitus are at risk for decreased bone mass,"
Dr. Moyer-Mileur stated that, "puberty is a critical time for additional bone mineral to be deposited into the skeleton." "This additional mineral deposition is thought to minimize the development of osteoporosis in later life."
To investigate further, the researchers studied 42 diabetics between 12 and 18 years old and 199 healthy regional reference subjects.
"Body size and maturation were similar between groups," the researchers note. However, at baseline and at 12 months, "diabetics had lower tibia, spine and whole body bone characteristics, but greater muscle mass and lower bone mineral content."
Annual gains for tibia cortical bone and whole body bone mineral content and muscle mass were lower in diabetics and were inversely related to HbA1c levels. However, "spine area and density and whole body muscle mass were greater and were predicted by pubertal-driven growth," they write.
Overall, the diabetics "had 8.5% less whole body bone mineral content to muscle mass, suggesting that bone mineral deposition was not adequately adapted to muscle gains," the investigators report.
"It appears that small but chronic alterations in bone mineral acquisition associated with hyperglycemia may prevent adolescents with type 1 diabetes from achieving optimal bone mass and strength."
Moreover, Dr. Moyer-Mileur added, "long-term studies are needed to determine whether our findings support an increase risk of osteoporosis in later life for individuals with type 1 diabetes who had poor glucose control during pubertal growth."
J Pediatr 2004;145:662-669.
FACT: The World Health Organization reports that at least 171 million people worldwide have diabetes and this figure is likely to more than double by 2030 to reach 366 million.