Nc. Thalassinos et al., CALCIUM-METABOLISM IN DIABETES-MELLITUS - EFFECT OF IMPROVED BLOOD-GLUCOSE CONTROL, Diabetic medicine, 10(4), 1993, pp. 341-344
Citations number
NO
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
Reduced bone mass occurring with increased frequency in diabetes melli
tus has been attributed to poor blood glucose control but the pathogen
etic mechanisms remain unknown. To evaluate the role of calcium metabo
lism, 59 patients with diabetes and normal renal function (22 Type 1,
37 Type 2) were studied. In all patients plasma calcium (Ca), serum ph
osphate (PO4)4 serum parathyroid hormone (PTH), and 24-h urinary calci
um (uCa) were determined under both poor and improved control (for at
least 7 days) as ascertained by four blood glucose determinations dail
y. Improvement of blood glucose control (p=0.001) was associated with
reduction of uCa both in Type 1 (6.9 +/- 1 vs 4.9 +/- 0.9 mmol day-1,
mean +/- SEM, p=0.02) and in Type 2 patients (4.2 +/- 0.4 vs 3.2 +/- 0
.4 mmol day-1, mean +/- SEM, p=0.002). Considerably more Type 1 patien
ts (10 out of 22) had PTH values below the detection limit (1.5 pmol l
-1) during poor than during improved control (2 out of 22). Comparison
between the two types of diabetes showed that in Type 1 under poor co
ntrol, Ca and PTH were lower (p=0.03), while uCa was higher (p=0.003),
and after improved control, only uCa continued to be higher (p=0.035)
. These findings suggest that increased uCa excretion in association w
itih 'functional hypoparathyroidism' (especially in Type 1 diabetes) i
s observed during poor blood glucose control, and may be one of the fa
ctors leading to reduced bone mass in diabetes mellitus.