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Metabolic control and bone health in adolescents with type 1 diabetes

Jill H Simmons1*, Miranda Raines1, Kathryn D Ness2, Randon Hall1, Tebeb Gebretsadik3, Subburaman Mohan4 and Anna Spagnoli5

Author Affiliations

1 Department of Pediatrics, Division of Endocrinology and Diabetes, Vanderbilt Children's Hospital, Nashville, TN, USA

2 Department of Pediatrics, Division of Pediatric Endocrinology, Seattle Children's Hospital, Seattle, WA, USA

3 Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA

4 Musculoskeletal Disease Center, Jerry L Pettis VA Medical Center, and Departments of Medicine and Biochemistry, Loma Linda University, Loma Linda, CA, USA

5 Department of Pediatrics, Division of Pediatric Endocrinology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

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International Journal of Pediatric Endocrinology 2011, 2011:13  doi:10.1186/1687-9856-2011-13

Published: 26 October 2011



Adults with type 1 diabetes (T1D) have decreased bone mineral density (BMD) and increased fracture risk, yet the etiologies remain elusive. Early detection of derangements in bone biomarkers during adolescence could lead to timely recognition. In adolescents with T1D, we evaluated the relationships between metabolic control, BMD, and bone anabolic and turnover markers.


Cross-sectional study of 57 adolescent subjects with T1D who had HbA1c consistently ≥ 9% (Poor Control, PC n = 27) or < 9% (Favorable Control, FC n = 30) for two years prior to enrollment. Subjects had T1DM for at least three years and were without diabetes complications, known celiac disease, or other chronic diseases.


There were no differences between HbA1c groups in BMD, components of the IGF system, or 25-hydroxyvitamin D status. The prevalence of 25-hydroxyvitamin D abnormalities was similar to that seen in the general adolescent population. Few patients met the recommended dietary allowance (RDA) for vitamin D or calcium.


These data provide no evidence of association between degree of metabolic control and BMD in adolescents with T1D. Adolescents with T1D have a high prevalence of serum 25-hydroxyvitamin D abnormalities. Longitudinal studies are needed to evaluate the predictive value of vitamin D abnormalities on fracture risk.

bone mineral density; intact parathyroid hormone; insulin-like growth factor; type 1 diabetes; adolescent