Evaluation of Bone Mineral Density in Children and Adolescents with Type 1 Diabetes

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by pancreatic beta cell loss that typically affects children and teenagers. Objective: To evaluate bone mineral density ((BMD)) in children and adolescents with T1DM. Methods: This case-control study was carried out on 100 children who were attending diabetes clinics at Menoufia University and Benha Insurance Hospitals. Children divided into two groups: Group 1 (n=50) children diagnosed T1DM, and Group 2 (n=50) completely apparently normal children, matched with patient group in age, sex, ethnicity, and socioeconomic level as controls. All patients were subjected to the following: Full History Taking, complete Clinical Examination. Laboratory Tests Included (serum vitamin D level, Serum calcium, phosphorus, serum alkaline phosphatase). BMD was assessed by DEXA scan at the Spine (L2- L4) and the femur.
Results: Between T1DM patients and controls, there was a substantial difference in levels of vitamin D, BMD, and alkaline phosphatase (p-value <0.001). Phosphorus and calcium levels were substantially different between the control group and patients with type 1 diabetes (p=0.045 and p=0.007, respectively). There was a very significant correlation between serum alkaline phosphatase (p-value < 0.001) and DEXA scan (z-score).
Conclusions: BMD and Vitamin D level of diabetic patients is lower than the control group. There was a significant difference between patients and controls regarding serum calcium and phosphorus levels, their values are lower in patients than controls.