ESPE Abstracts (2019) 92 P1-22

Differences in Bone Strength and Cortical Bone Parameters in Young Swedish Women with Type 1 Diabetes

Eva Kristiansen1, Daniel Novak1,2, Gun Forsander1,2, Anna Svedlund1,2, Per Magnusson3, Diana Swolin-Eide1,2


1Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Department of Pediatrics, Gothenburg, Sweden. 2Department of Pediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3Department of Clinical Chemistry, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden


Background: The incidence of Type 1 diabetes (T1D) is rising globally and fractures are common.

Objective: To investigate bone health in young females with a T1D duration of at least 10 years in relation to healthy, matched controls.

Subjects: Twenty-three Swedish females, aged 19.2– 27.9 years, with a T1D duration of ≥10 years, were recruited from the Swedish National Diabetes Registry (NDR). A healthy control group, matched for age, gender and geography was used for comparison.

Methods: Dual-energy X-ray absorptiometry and peripheral quantitative computed tomography (pQCT) were used to assess bone mass. Data regarding the T1D participants was retrieved from both the NDR and the national Swedish Paediatric Diabetes Quality Registry (SWEDIABKIDS). A questionnaire regarding current diseases, previous fractures and degree of physical activity was used.

Results: The individuals with T1D had an average diabetes duration of 18.9 years and a long-term suboptimal or poor metabolic control. No differences were found between the study groups for weight and body mass index (BMI). Females with T1D were significantly shorter than individuals in the control group.

No differences were found between the T1D and control groups for total, lumbar spine and femur areal bone mineral density, or for lumbar spine bone mineral content (BMC). Total body BMC was lower in the T1D group in comparison with the control group; however, this difference was no longer apparent when total body BMC was adjusted for BMI, physical activity and height.

Data from the pQCT measurements did not reveal any differences between the T1D and control groups for trabecular density, cortical area, cortical thickness, endosteal or periosteal circumference. However, a higher cortical density (when adjusted for BMI, physical activity and height) was observed for the T1D group, (p-value 0.020). The bone strength index of cortical bone, SSI, was significantly lower among females with T1D.

Conclusions: This study demonstrates decreased bone strength and altered cortical bone parameters in young females with long-duration T1D in comparison with healthy matched controls. These factors contribute to the health burden, which warrants further attention towards improving bone health in patients with T1D.

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