PERIPHERAL OSTEOPENIA IN ADULT PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS

Alterations in bone metabolism in diabetes mellitus is a topic of spec ial interest. Bone blood flow is increased in the distal limb of diabe tic patients, which is believed to increase osteoclastic activity. We measured bone mineral density using dual-photon absorptiometry in the distal lower limb, the femoral neck, and the lumbar spine in 41 IDDM p atients and in 30 control persons. In the diabetic group there was a 1 0 % reduction of bone mineral density in the femoral neck (p < 0.01) a nd a 12 % reduction in the distal limb (p < 0.001) compared with the c ontrol group. No significant difference was found in the lumbar spine (p = 0.22). Our data yield incidence for peripheral osteopenia in IDDM -patients, independent of any systemic bone diseases such as osteoporo sis. A link between decreased bone mineral density and diabetic neurop athy has been observed for the femoral neck (p < 0.001), but not for t he distal limb or axial skeleton. Whether there is a common aetiologic al link or a causal connection between diabetic neuropathy and bone mi neral density has still to be determined.