Abstract
Patients with Type 1 Diabetes Mellitus (DM) have markedly increased risk of fracture, but little is known about abnormalities in bone micro-architecture or remodeling properties that might give insight into the pathogenesis of skeletal fragility in these patients. This is a case-control study comparing bone histomorphometric results from iliac biopsies in 18 otherwise healthy subjects with Type 1 Diabetes Mellitus with those from healthy age- and sex- matched non-diabetic control subjects. Five of the diabetics had histories of low-trauma fracture. Transilial bone biopsies were obtained after tetracycline labeling. The biopsy specimens were fixed, embedded, sectioned and quantitative histomorphometry was performed as previously described (Recker et al., 1988). Two sections, >250 µm apart, were read from the central part of each biopsy. Overall there were no significant differences between diabetics and controls in histomorphometric measurements. However, fracturing diabetics had structural and dynamic trends different from nonfracturing diabetics. In conclusion, Type 1 Diabetes Mellitus does not result in abnormalities in bone histomorphometric variables in the absence of manifest complications from the diabetes. However, diabetics suffering fractures may have defects in their skeletal microarchitecture that may underlie the presence of excess skeletal fragility.