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Subjects with type 1 diabetes mellitus (T1DM) have decreased bone mineral density and an up to sixfold increase in fracture risk. Yet bone fragility is not commonly regarded as another unique complication of diabetes. Both animals with experimentally induced insulin deficiency syndromes and patients with T1DM have impaired osteoblastic bone formation, with or without increased bone resorption. Insulin/IGF1 deficiency appears to be a major pathogenetic mechanism involved, along with glucose toxicity, marrow adiposity, inflammation, adipokine and other metabolic alterations that may all play a role on altering bone turnover. In turn, increasing physical activity in children with diabetes as well as good glycaemic control appears to provide some improvement of bone parameters, although robust clinical studies are still lacking. In this context, the role of osteoporosis drugs remains unknown.

Original publication

DOI

10.1530/EJE-15-0820

Type

Journal article

Journal

Eur j endocrinol

Publication Date

04/2016

Volume

174

Pages

R127 - R138

Keywords

Adiposity, Bone Density, Bone Diseases, Metabolic, Bone Marrow, Bone Remodeling, Diabetes Mellitus, Type 1, Fractures, Bone, Humans, Risk Factors