Search
Search titles only
By:
Search titles only
By:
Home
Forums
New posts
Search forums
What's new
New posts
New profile posts
Latest activity
Members
Current visitors
New profile posts
Search profile posts
Log in
Register
Search
Search titles only
By:
Search titles only
By:
New posts
Search forums
Menu
Install the app
Install
Reply to Thread
Guest, we'd love to know what you think about the forum! Take the
Diabetes Forum Survey 2024 »
Home
Forums
Diabetes Discussion
Type 1 Diabetes
I've been told to increase HbA1c to improve hypo awareness
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Message
<blockquote data-quote="LucySW" data-source="post: 938910" data-attributes="member: 113749"><p>I never knew about this association between Type 1 D and osteoporosis. </p><p></p><p>Just on a quick google, found this: </p><p></p><p>" Some studies have shown stabilized and improved BMD in patients with type 1 diabetes with improved glucose control over time.40,41 Hypercalciuria, a potential risk factor for osteoporosis, has long been noted in patients with poorly controlled type 1 diabetes42,43 or type 2 diabetes,44,45 and was shown to improve with lower A1C results.46 Thus, metabolic control appears to be a major factor in the increased incidence of osteoporosis in patients with diabetes. However, poor control cannot be the only factor unless there is a compensatory factor increasing BMD in type 2 diabetes.</p><p></p><p>If the relationship between osteoporosis and diabetes were only related to hyperglycemia, one would expect a similar incidence of osteoporosis in patients with type 1 and those with type 2 diabetes, but most studies show more osteoporosis in patients with type 1 diabetes.31,47 There may be differences between types of diabetes other than glucose control that affect BMD. Several factors have been investigated, including treatment with insulin, endogenous insulin levels, age of onset, and A1C, but the actual mechanism for lower BMD in type 1diabetes is not known.</p><p></p><p></p><p>Krakauer et al.40 and Tuominen et al.31 have separately compared patients with type 1 and type 2 diabetes treated with insulin, showing that exogenous insulin is not the cause of the bone loss. Krakauer et al. also found decreased BMD in men and women with type 1 diabetes as compared with those with type 2 diabetes or with control subjects.</p><p></p><p></p><p>Epidemiological studies at Rancho Bernardo, Calif.,48 and in Rotterdam, The Netherlands,49 suggested correlations between fasting and post-challenge insulin levels and BMD in women without diabetes, but in the Rotterdam group only, these lost significance after adjusting for BMI. In patients with type 2 diabetes, no consistent association of BMD with endogenous insulin levels, using fasting or post-challenge levels, has been found.34,50,51 However, insulin levels are quite variable within type 2 diabetes because of the decline of β-cell function over the course of the disease.</p><p>An autoimmune- or inflammation-mediated process has also been considered because a decrease in BMD has been noted during the first several months to years after diagnosis, with an attenuation thereafter.27,37,52 This suggests an initial insult not specifically related to control, but perhaps to the autoimmune process, similar to that seen in rheumatoid arthritis, in which bone loss is seen in the involved joints.</p><p></p><p></p><p>Increasing evidence suggests that type 1 diabetes in particular may impede new bone formation possibly because of defective function of osteoblasts, the primary cells responsible for bone formation.53,54 Preliminary data suggest that poorly controlled diabetes with hyperglycemia and consequently increased osmolarity contribute to decreased osteoblast function.53 In addition, patients with type 1 diabetes are known to have lower levels of insulin-like growth factor I, an anabolic hormone that maintains healthy bone formation.55"</p><p></p><p></p><p>From this : <a href="http://m.clinical.diabetesjournals.org/content/22/1/10.full" target="_blank">http://m.clinical.diabetesjournals.org/content/22/1/10.full</a></p></blockquote><p></p>
[QUOTE="LucySW, post: 938910, member: 113749"] I never knew about this association between Type 1 D and osteoporosis. Just on a quick google, found this: " Some studies have shown stabilized and improved BMD in patients with type 1 diabetes with improved glucose control over time.40,41 Hypercalciuria, a potential risk factor for osteoporosis, has long been noted in patients with poorly controlled type 1 diabetes42,43 or type 2 diabetes,44,45 and was shown to improve with lower A1C results.46 Thus, metabolic control appears to be a major factor in the increased incidence of osteoporosis in patients with diabetes. However, poor control cannot be the only factor unless there is a compensatory factor increasing BMD in type 2 diabetes. If the relationship between osteoporosis and diabetes were only related to hyperglycemia, one would expect a similar incidence of osteoporosis in patients with type 1 and those with type 2 diabetes, but most studies show more osteoporosis in patients with type 1 diabetes.31,47 There may be differences between types of diabetes other than glucose control that affect BMD. Several factors have been investigated, including treatment with insulin, endogenous insulin levels, age of onset, and A1C, but the actual mechanism for lower BMD in type 1diabetes is not known. Krakauer et al.40 and Tuominen et al.31 have separately compared patients with type 1 and type 2 diabetes treated with insulin, showing that exogenous insulin is not the cause of the bone loss. Krakauer et al. also found decreased BMD in men and women with type 1 diabetes as compared with those with type 2 diabetes or with control subjects. Epidemiological studies at Rancho Bernardo, Calif.,48 and in Rotterdam, The Netherlands,49 suggested correlations between fasting and post-challenge insulin levels and BMD in women without diabetes, but in the Rotterdam group only, these lost significance after adjusting for BMI. In patients with type 2 diabetes, no consistent association of BMD with endogenous insulin levels, using fasting or post-challenge levels, has been found.34,50,51 However, insulin levels are quite variable within type 2 diabetes because of the decline of β-cell function over the course of the disease. An autoimmune- or inflammation-mediated process has also been considered because a decrease in BMD has been noted during the first several months to years after diagnosis, with an attenuation thereafter.27,37,52 This suggests an initial insult not specifically related to control, but perhaps to the autoimmune process, similar to that seen in rheumatoid arthritis, in which bone loss is seen in the involved joints. Increasing evidence suggests that type 1 diabetes in particular may impede new bone formation possibly because of defective function of osteoblasts, the primary cells responsible for bone formation.53,54 Preliminary data suggest that poorly controlled diabetes with hyperglycemia and consequently increased osmolarity contribute to decreased osteoblast function.53 In addition, patients with type 1 diabetes are known to have lower levels of insulin-like growth factor I, an anabolic hormone that maintains healthy bone formation.55" From this : [URL]http://m.clinical.diabetesjournals.org/content/22/1/10.full[/URL] [/QUOTE]
Verification
Post Reply
Home
Forums
Diabetes Discussion
Type 1 Diabetes
I've been told to increase HbA1c to improve hypo awareness
Top
Bottom
Find support, ask questions and share your experiences. Ad free.
Join the community »
This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies.
Accept
Learn More.…