Comparative Study of BMD in Type 2 Diabetic and Non-diabetic Male Patients

Abstract

Introduction: Osteoporosis and diabetes are both common human diseases. The prevalence of both is increasing individually and in combination, due to better detection methods and changing definitions. Due to the different pathogenesis of Type 1 and Type 2 diabetes mellitus (T2DM), one of which is a predominant autoimmune process while the other mainly a metabolic disorder, it is not surprising that there is no uniform entity of diabetic bone disease as such, although such term has been proposed in the past but never gained momentum. Paradoxically, an increased risk of osteoporotic fracture in T2DM has been repeatedly demonstrated and this was independent of bone mineral density (BMD). This association with fracture adds uncertainty around the actual association between diabetes mellitus and BMD. This study aims to study the population of diabetes at tertiary care center when they are compared with non-diabetics in terms of BMD. Aims of Study: The aim of this study was to determine the prevalence of osteopenia and osteoporosis in T2DM and non-diabetic male patients using Dual Energy X-ray absorptiometry (DEXA scan). Materials and Methods: Patients for the study included male patients between 40 and 60 years of age group attending outpatient department, health checkup, and admitted in the ward of Saifee Hospital, Department of Medicine. In 200 (100 type 2 diabetic males and 100 non-diabetic males), DEXA Scan was performed in the Department of Imaging, Saifee Hospital from June 2017 to April 2019. Results: Type 2 diabetics were significantly associated with the presence of osteoporosis compared to non-diabetics (P = 0.001). Type 2 diabetics were significantly associated with body mass index (BMI) >25 (P = 0.0) and diabetics had a significantly higher BMI compared to non-diabetics (P = 0.0001). Type 2 diabetics above 50 years of age were significantly associated with osteoporosis (P = 0.000) and diabetics with osteoporosis were significantly older compared to diabetics without osteoporosis (P = 0.0018). Conclusion: The study concluded that there is a correlation between T2DM, increasing age, glycemic control, increased BMI, increased calcium levels, and decreased BMD. Thus, physician treating diabetes must anticipate decreased BMD and rule out or correct all of these factors in patients of diabetes to prevent the complications of decreased BMD in these groups of patients. Therefore, early detection and treatment of osteoporosis/osteopenia by estimation of BMD in Type 2 diabetic males, strict diabetic control with target hemoglobin A1c <6.5, weight control with target BMI <25, supplementation with Vitamin D3 should be advocated. Keywords: Diabetes, osteoporosis, dual-energy X-ray absorptiometry scan.