Bone metabolism in type 2 diabetes mellitus

Several conditions have been described to cause osteoporosis, including dia betes mellitus. While the relation ship between type 1 diabetes and osteope nia is well documented in the literature, data on the presence of this comp lication in type 2 diabetes have not been well established. We studied a po pulation composed of 66 post-menopausal women with type 2 diabetes and a co ntrol population. We examined bone mineral density with the dual-energy X-r ay absorptiometry (DXA) technique at the lumbar and femoral levels and, in a subgroup of patients,we also measured the levels of markers of bone remod elling. We found significantly higher levels of bone mineral density at the femoral (but not lumbar) level in the diabetic subjects compared with the control population in all the examined subregions, except Ward's triangle. Moreover, we found higher levels of some markers of bone resorption (urinar y calcium and hydroxyproline, telopeptide) in the patients with diabetes, w hile urinary crosslinks were higher in the controls. On the basis of these results, we suggest that osteoporosis cannot be considered a complication o f type 2 diabetes and that, from a metabolic point of view, bone resorption is greater in diabetic patients than in normal subjects, as suggested by t he high levels of most of the markers of osteoclastic activity.