Endocrine Abstracts

Introduction: The improvement of the survival of diabetics is accompanied by the emergence of bone fragility which can directly affect, at various levels, the various components of the bone tissue leading to quantitative and qualitative anomalies. The effects of type 2 diabetes on bone are complex because they are associated with the sometimes associated disorders of nutrition, weight and age. Densitometric studies in this context are quite contradictory. We proposed to study the bone status of type 2 diabetics.

Patients and methods: We carried out a cross-sectional study of 290 type 2 diabetics. These patients benefited from a measurement of bone mineral density (BMD) associated with PTH, vitamin D and calcemia.

The results: The average age of our population was 62.5 years. 38% of our patients were treated with insulin with a predominantly mixed regimen (basal insulin combined with oral treatments), with an average HBA1C of 7.05% for an average duration of diabetes of 8 years. Mean calcium in the general population was 2.33 mmol/l, with 2.36 mmol/l in males and 2.27 mmol/l in females, with no significant relationship between the two sexes (P=0.1370).

5 patients had secondary hyperparathyroidism (> 65 pg/ml), the mean PTH in the study population was 46.82 ng/ml, higher in women than in men. 75.6% of patients had normal BMD, 23.3% had osteopenia, 24.3% were women, and 21% were men. The mean concentration of vitamin D is 13.93 ng/ml, with a maximum of 35 ng/ml and a minimum of 3 ng/ml. The mean concentration in males was 15, 14 ng/ml, significantly higher than that of females in the order of 11.91 ng/ml (P<0.1=P=0.0018). A negative and significant correlation was found between the serum levels of 25OHD3 and those of PTH. This correlation persisted after adjusting for age and BMI. Our study did not find any significant relationship between PTH levels and BMD scores with (P=0.6091).

Conclusion: According to data from the literature and despite normal BMD in patients with type 2 diabetes, it should be borne in mind that BMD alone is insufficient to assess bone status, management of other factors such as Diet rich in vitamin D and sufficient calcium intake is required.