Type 1 diabetes and low bone mineral density are not a common combination

Children with type 1 diabetes (T1D) have similar bone mineral density (BMD) levels to children without the disease, according to findings from a cross-sectional, case-control study conducted in an outpatient clinic in India. However, those with T1D had lower vitamin D levels than their peers without T1D, the study results showed.

Study participants were 37 children with T1D (mean age of 10 years) who require insulin to maintain normal blood glucose level and 37 children without T1D (mean age of 9.7 years). All participants underwent dual-energy x-ray absorptiometry scan of the lumbar spine and measurements of various bone health parameters, such as serum osteocalcin level, deoxypyridinoline level, serum vitamin D level, phosphorus and calcium levels, and alkaline phosphatase level.

Only 3 children with T1D (8%) had a low BMD level compared with none in the control group. However, serum 25-hydroxyvitamin D (25[OH]D) level was significantly lower in the T1D group than in the control group, and serum-intact parathyroid hormone level was substantially higher. Bone mineral content was similar in the 2 groups, as were all other bone turnover variables.

Thoughts From Dr Farber

Children with T1D have enough to worry about; it is reassuring we can cross BMD off the list (at least in childhood). Vitamin D supplementation has been called into question recently but given the elevated parathyroid hormone levels seen in the study results, it seems worth reconsidering.

Reference

Kumar RA, Kumar CGD, Sahoo J. Evaluation of bone mineral density in children with type 1 diabetes: a cross-sectional case–control study. JPED. 2022;2(1):9-13. doi:10.25259/JPED_1_2022