Improvement in HbA1c appears to mitigate bone mineral density loss and bone turnover among adults with type 1 diabetes, according to study findings presented at the European Congress of Endocrinology.
Eleftheria Barmpa, of the department of endocrinology and metabolic disease at the University of Thessaly in Larissa, Greece, and colleagues analyzed data from 107 patients with type 1 diabetes (mean age, 34 years; 48 men; mean duration of diabetes, 15 years; mean BMI, 23.2 kg/m²; mean HbA1c, 8.2%) and 95 healthy controls matched for age, sex and BMI. Patients underwent DXA scans of the lumbar spine and femoral neck. In both groups, researchers measured HbA1c, bone resorption (assessed by beta-CTx) and bone formation (assessed by serum levels of total procollagen type 1 N-terminal propeptide, or tP1NP). Within the diabetes group, 50 patients underwent the same measurements at 1 year.
At baseline, mean BMD was lower for patients in the diabetes group vs. controls at the lumbar spine (1.024 vs. 1.052; P = .04) and femoral neck (0.696 vs. 0.898; P = .042); T-score also was lower for patients with diabetes at both sites (lumbar spine, –0.3 vs. 0.9; P = .02; femoral neck, –0.1 vs. 1.4; P = .038). There were no between-group differences in beta-CTx or tP1NP.
At 1 year, 36 of the 50 returning patients with diabetes experienced a 0.5% or greater reduction in HbA1c; eight patients maintained their baseline HbA1c; six patients saw at least a 0.5% increase in HbA1c. Among the 36 patients who experienced a decrease in HbA1c, there was a mean 3.3% increase in BMD at the lumbar spine and a 5.6% increase at the femoral neck; tP1NP also was higher compared with baseline (P = .043).
“Improvement of glycemic control appears to ameliorate BMD and bone turnover and could help to stabilize the bone mass in these patients,” the researchers wrote. “Identifying the factors that affect bone in patients with [type 1 diabetes] can help to improve the health of their bones.” – by Regina Schaffer
Barmpa E, et al. Abstract GP88. Presented at: European Congress of Endocrinology; May 28-31, 2016; Munich.
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