Teens with diabetes may face future bone frailty

Despite normal growth and maturation, young people with type 1 diabetes appear to lag in bone development, researchers report.

"Puberty is a critical time for additional bone mineral to be deposited into the skeleton," Dr. Laurie J. Moyer-Mileur told Reuters Health. "This additional mineral deposition is thought to minimize the development of osteoporosis in later life."

However, recent observations "suggest that children and adolescents with type 1 diabetes mellitus are at risk for decreased bone mass," Moyer-Mileur of the University of Utah, Salt Lake City, and colleagues note in the Journal of Pediatrics.

To look into this, the researchers studied 42 diabetics between 12 and 18 years old and compared them with 199 healthy subjects from the same region.

"Body size and maturation were similar between groups," the researchers note. Nonetheless, "diabetics had lower tibia, spine and whole body bone characteristics, but greater muscle mass and lower bone mineral content."

Annual gains in bone mineral content were lower in diabetics, and this was related to poorer control of blood glucose levels. However, whole body muscle mass was greater, the team found.

Overall, the diabetics "had 8.5 percent less whole body bone mineral content to muscle mass, suggesting that bone mineral deposition was not adequately adapted to muscle gains," the investigators report.

They say that "small but chronic alterations in bone mineral acquisition" associated with high blood sugar levels "may prevent adolescents with type 1 diabetes from achieving optimal bone mass and strength."

What does this mean down the road? "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." Moyer-Mileur commented.

SOURCE: Journal of Pediatrics, November 2004.