title: Poor glycemic control is associated with low BMD detected in premenopausal women with type 1 diabetes.
abstract: CONCLUSIONS
  The etiology of bone fragility in individuals with type 1 diabetes is unknown. This study demonstrated that bone turnover favors resorption and that poor glycemic control is associated with low bone mineral density (BMD) and low bone turnover, in premenopausal women with type 1 diabetes. The results could inform future interventions.
  
  
  BACKGROUND
  Low BMD and fracture may be complications of type 1 diabetes. We sought to determine the roles of bone turnover and glycemic control in the etiology of low BMD.
  
  
  METHODS
  Premenopausal women from the Wisconsin Diabetes Registry Study and matched controls were compared (n = 75 pairs). Heel and forearm BMD were measured, and hip and spine BMD were measured in a subset. Markers of bone formation (osteocalcin) and resorption (NTx), and glycemic control (HbA1c) were determined.
  
  
  RESULTS
  Age ranged from 18 to 50 years with a mean of 28, and 97% were Non-Hispanic white. Among women with diabetes, mean disease duration was 16 years and current HbA1c was 8%. Compared to controls, women with diabetes had a high prevalence of previous fracture (37% vs. 24%) and low BMD for age (heel or forearm: 49% vs. 31%), low heel and forearm BMD, and low osteocalcin levels. Levels of NTx were similar, suggesting uncoupled turnover favoring resorption. Poor glycemic control was associated with low BMD at all bone sites except the spine, and with low osteocalcin and NTx levels.
  
  
  CONCLUSIONS
  Optimal glycemic control may prevent low BMD and altered bone turnover in type 1 diabetes, and decrease fracture risk.
authors.affiliation: Institute for Endocrine Discovery and Clinical Care, University of Chicago, Chicago, IL, USA. kdaniels@peds.bsd.uchicago.edu
authors.forename: K K
authors.initials: KK
authors.lastname: Danielson
authors.forename: M E
authors.initials: ME
authors.lastname: Elliott
authors.forename: T
authors.initials: T
authors.lastname: LeCaire
authors.forename: N
authors.initials: N
authors.lastname: Binkley
authors.forename: M
authors.initials: M
authors.lastname: Palta
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology; D001862:Bone Resorption / Q000378:metabolism*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism; D017697:Premenopause / Q000502:physiology; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging / Q000378:metabolism; D011795:Surveys and Questionnaires; D014457:Ulna / Q000000981:diagnostic imaging / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D015675:Osteocalcin