Metabolic control and bone health in adolescents with type 1 diabetes

Cross-sectional study of 57 adolescent subjects with T1D who had HbA1c consistently ≥ 9% (Poor Control, PC n = 27) or < 9% (Favorable Control, FC n = 30) for two years prior to enrollment. Subjects had T1DM for at least three years and were without diabetes complications, known celiac disease, or other chronic diseases.There were no differences between HbA1c groups in BMD, components of the IGF system, or 25-hydroxyvitamin D status. The prevalence of 25-hydroxyvitamin D abnormalities was similar to that seen in the general adolescent population. Few patients met the recommended dietary allowance (RDA) for vitamin D or calcium.These data provide no evidence of association between degree of metabolic control and BMD in adolescents with T1D. Adolescents with T1D have a high prevalence of serum 25-hydroxyvitamin D abnormalities. Longitudinal studies are needed to evaluate the predictive value of vitamin D abnormalities on fracture risk.The effects of improved home blood glucose monitoring, pharmacotherapy, and educational interventions have led to a longer lifespan for patients with type 1 diabetes mellitus (T1D). However, bone health remains a problem for many with T1D, as adults with T1D have increased fracture risk and generalized osteoporosis [1,2], and abnormalities in bone mineral density (BMD) have been reported in adolescents with T1D. The underlying mechanisms triggering the changes in BMD in patients with T1D are not well-known. Reports of the relationships between metabolic control, BMD, and bone marker parameters in patients with T1D have been conflicting [3,4]. Evaluations of bone disease in adults with T1D are generally complicated by the presence of other diabetic complications such as nephropathy, muscle insufficiency, or impaired vision that can affect bone disease. Early detection, prior to other diabetes complications, of derangements in bone markers can provide insight into the pathogenesis of bone disease in patients with T1D.Bone health is dependen