[Diabetic osteopathies. 1. Etiologic factors and theoretical prerequisites for the development of bone...

The causes of impaired calcium, phosphorus and vitamin D metabolism in diabetic patients which in the long run lead to demineralization of bone can be summarized into several main groups. Above all disorders of calcium absorption from the small intestine are involved, associated with impaired absorption of vitamin D and its reduced conversion into active metabolites in the liver and kidneys. An increased elimination of calcium from the organism may also play a part (hypercalciuria, excretion in the faeces and sweat), hormonal changes (secondary hyperparathyroidism) and finally changes in the metabolism of the organic bone constituent--osteoid. Subsequent work will deal with the prevalence of osseous changes in diabetics, early diagnosis and rational treatment and possible prevention of these changes.