Vitamin D, calcium, phosphates, and magnesium serum level and bone mineral density in patients with type 1 diabetes

Abnormal glucose metabolism, which is a common condition in patients with type 1 diabetes (T1DM), triggers a number of changes in various organs. Additionally, elevated blood glucose level also affects the bones. Bone mineral density (BMD), vitamin D, calcium, phosphates, and magnesium serum concentrations are significant factors assessed in bone metabolism. In this study, we evaluated these factors and the impact of vitamin D supplementation on vitamin D and BMD levels in T1DM patients.

The study included 66 adults with T1DM and a control group of 66 healthy adults of the same age and weight. Densitometric measurements of the lumbar spine (L1-L4) and femoral neck (FN) were performed using dual-energy X-ray absorptiometry. The concentration of vitamin D, calcium, phosphates, and magnesium in the blood was assessed. All patients completed a questionnaire regarding vitamin D supplementation and symptoms associated with osteoporosis.

Significant differences in the range, BMD, Z-score and T-score for FN and L1-L4 were observed in diabetic and non-diabetic subjects. Only 50% of participants with diabetes and osteopenia and only 40% of diabetic patients without osteopenia showed optimal vitamin D concentration. There were no differences in BMD, T-score and Z-score of FN, as well as in L1-L4 between the subjects who supplemented and those who did not supplement vitamin D.

Patients with T1DM are more at risk of developing osteoporosis than healthy individuals. Vitamin D may not be the only factor affecting BMD. Patients with T1DM should be screened for osteoporosis and other complications. Patients with type 1 diabetes should receive higher doses of vitamin D than healthy adults and control their calcium, magnesium and phosphates serum concentrations.