Endocrine Abstracts

Introduction: Osteoporosis is a generalized skeletal disease that combines a decrease in bone density with changes in bone microarchitecture. The bone is abnormally fragile and therefore the risk of fracture is high. We report the case of osteoporosis in a young woman secondary to type 1 diabetes mellitus (T1DM).

Case Report: Patient A.M, 26 years old, with a history of polyglandular autoimmune syndrome type 3 since the age of 12, associating T1DM and Hashimoto’s thyroiditis, was admitted to hospital for investigation of a spontaneous fracture of the right carpal bone. Bone densitometry (BMD) showed a T score of -3.4 standard deviations (SD) in the spine and -2.6 SD in the femoral neck, confirming the diagnosis of osteoporosis. The etiological investigation was negative. Metabolic, pharmacological, endocrine (hyperthyroidism/hyperparathyroidism), hormonal, deficiency (osteomalacia) and nutritional causes were ruled out and the diagnosis of osteoporosis secondary to diabetes mellitus was retained.

Discussion/Conclusion: Chronic hyperglycaemia adversely affects bone by altering qualitative and quantitative bone formation due to the direct toxic effects of glucose on the osteoblast. In addition, diabetes leads to impaired microcirculation which may interfere with bone repair. Most studies have shown a decrease in BMD in patients with diabetes. Diabetes is therefore associated with an increased risk of fracture through osteoporosis. These findings should be kept in mind for optimal management of our patients with diabetes.