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Important New Bone density Screening Update for People with Type 1 Diabetes

A recent study compared bone density and bone strength of people with longstanding, well-managed, Type 1 Diabetes to bone density of people without diabetes.  The study reports there was a significant reduction in bone density and bone strength in certain areas of the body in people with Type 1 Diabetes compared to people without Diabetes.

People living with Type 1 Diabetes have an increased risk for bone fractures and osteoporosis.  However, it was previously unclear if there is a difference in bone density between people with longstanding and well-managed Type 1 Diabetes compared to people with chronically very elevated glucose levels. The average age of the participants in this study was 60 years old with a duration of Type 1 Diabetes of 37.7 years. The average A1C of the group was 6.8% with the prior 2-, 5-, 7-, and 10-year A1C’s averaging at or below 7%.

bone density

This study showed there was a greater reduction in bone density and bone strength in people with Type 1 Diabetes compared to people without Diabetes.  The study showed the greatest decrease in bone density is for people with Type 1 Diabetes who also have Neuropathy (damage to nerves in the body) compared to those without Neuropathy.

Neuropathy is the most common Long-Term Complication for those with long-standing Type 1 Diabetes.  It is estimated that about 54% of people with Type 1 Diabetes have some form of Neuropathy.  The risk for Neuropathy increases the longer someone lives with Type 1 Diabetes.

Decreased bone density and decreased bone strength increase the risk for fractures (breaks).

The study also confirmed that decreased bone strength also contributes to slower mobility.  It is unknown if slower mobility contributes to decreased bone strength and bone density due to less physical activity, or vice versa.

The American Diabetes Association’s Medical Guidelines recommend a baseline scan to evaluate bone density in people with Type 1 or Type 2 diabetes using the same guidelines as the general population. A baseline bone density scan is recommended starting at age 50 for men and at the beginning of menopause for women.

Treatment for osteopenia or osteoporosis is the same for people with diabetes as the general population and could include adequate calcium and vitamin D intake, regular physical activity, and supplements, and for many people, prescribed medication(s).

If you have Type 1 Diabetes, ask your Diabetes Educator and your Endocrinologist if you are eating enough calcium and if your Vitamin D level is normal.  If you aren’t participating in regular weight-bearing physical activity, talk to your diabetes educator for help getting a plan started.

Be sure to talk to your Primary Care Physician or your Endocrinologist if it is time to get your first Bone Mineral Density test scheduled!  

To review the study yourself, check out:

Sewing L, Potasso L, Bauman S, et al. Bone microarchitecture and strength in long-standing type 1 diabetes. J Bone Miner Res. Published online January 29, 2022. doi: 10.1002/jbmr.4517

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