Peripheral Osteopenia in Adult Patients with Insulin‐dependent Diabetes Mellitus

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Abstract
Alterations in bone metabolism in diabetes mellitus is a topic of special interest. Bone blood flow is increased in the distal limb of diabetic 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 patients and in 30 control persons, In the diabetic group there was a 10 % reduction of bone mineral density in the femoral neck (p < 0.01) and a 12 % reduction in the distal limb (p < 0.001) compared with the control 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 osteoporosis. A link between decreased bone mineral density and diabetic neuropathy has been observed for the femoral neck (p < 0.001), but not for the distal limb or axial skeleton. Whether there is a common aetiological link or a causal connection between diabetic neuropathy and bone mineral density has still to be determined.