The effect of diabetes mellitus on bone metabolism and bone mineral density is discussed
controversially. Diabetes mellitus due to an autoimmune process seems to be associated
with low turnover osteopenia either in the animal model or in children and adolescents.
A number of factors are discussed as being involved, but in this age group clinical
symtoms are missing. Adult patients of either sex with IDDM show a reduced bone mineral
density when measured at peripheral sites such as the distal forearm or the femoral
neck, diabetic complications such as neuropathy and microangiopathy seem to pronounce
the deficit of bone mass. In these patients, osteopenia is accompanied by a high turnover
situation of bone metabolism, possibly due to microvascular complications. In contrast,
patients with NIDDM and here especially overweight women have a normal or even increased
bone mineral density. Up to now, there is no convincing evidence for an increased
incidence of osteoporotic fractures in diabetic patients. Systemic diabetic osteopenia
therefore does not seem to be of great epidemiological relevance.
Key words
Osteopenia - Diabetes mellitus - Bone mineral density - Bone turnover
