The main aim of management of insulin dependent diabetes (IDDM) is to prevent the acute as well as the long term complications, Recent studies suggest that IDDM in children is associated with significantly reduced bone mass density (BMD) values which may manifest as osteopenia in the growing bone. We hereby report three cases of IDDM males who were found to have low BMD and review the literature concerned with this issue.
Case 1: Eighteen years old, Kuwaiti boy known to have IDDM for last 8 years. His serum glucose is fairly well controlled with 9% HbA1C.
Case 2: Eighteen years old, Kuwaiti boy known to have IDDM for last 5 years. His serum glucose is well controlled with 7% HbA1C.
Case 3: Nineteen years old, Kuwaiti boy known to have IDDM for last 10 years. His serum glucose is poorly controlled with 12% HbA1C. BMD was measured due to their complain of bone ache. The lumbar spine Z-scores BMD was significantly lower at the vertebrae (osteopenic range) than those of healthy population at the same age.
Conclusion & recommendation Young males with type 1 diabetes exhibit significantly lower BMD values at the vertebrae which may be manifested as osteopenia in the growing bone. This may not be a late complication of type 1 diabetes and seems not to be related to the duration of the disease or to glycemic control. Therefore we recommend bone density scan for all young males with type-1- diabetes to measure BMD and try to prevent diabetic osteopenia through therapeutic intervention.
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