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Abstract
IDDM in children and adolescents is associated with osteopenia, which is significantly correlated with the disease duration and metabolic control. Serum calcium is significantly lower in diabetic patients compared to controls. Serum phosphorus and alkaline phosphatase were within normal in diabetic patients.
Longitudinal studies on bone development in type 1 diabetes are sparse. Longitudinal data on skeletal growth and mineral acquisition are necessary to distinguish between temporal or long-term effects of diabetes on bone development.
The foundation for lifelong skeletal health is established during childhood and adolescence .although there is controversy regarding the exact timing of peak bone mass, bone size and strength reach a maximum by early adulthood. Failure to achieve optimum peak bone mass has been linked to an increased risk of osteopenia. Longitudinal studies also necessary to reveal the link between diabetic vascular complications like nephropathy and osteopenia and to follow the effects of diabetes and nephropathy on parathyroid hormone, vitamin d and calcium homeostasis.
Other factors stated in cross-sectional studies to contribute in osteopenia in type 1 diabetes needs more longitudinal studies like: insulinopenia, c-peptide chain, IGF-1, hyperglycemia ...
Waiting for more studies to reveal the exact etiology of osteopenia in children and adolescents with type 1 diabetes, risk factors should be avoided.
Good control of diabetes and diet control will decrease complications including nephropathy and osteopenia. Optimal calcium intake is necessary to achieve peak bone mass and decrease incidence of osteopenia in children and adults. Encouraging regular exercise shown to increase bone mass in children. Regular monitoring of blood sugar and calcium parameters are essential for all children with diabetes type 1.
Calcuim supply to all children with type 1 diabetes as a routine diatery supply.
Routine Daxa examination to all patients of type 1 diabetes to detect early osteopenia.