“STUDY OF THE EFFECT OF DIABETIC CONTROL AND COMPLICATIONS ON BONE MINERAL DENSITY IN TYPE 2 DIABETIC PATIENTS”
Azhar Ali Khan, Virendra Kumar Yadav* and Rajendra Vaidya
ABSTRACT
Background: Type 2 DM is still remains one of the leading causes of morbidity and mortality. Diabetic patients are more prone to osteoporosis. The development of osteoporosis in diabetes is also promoted by the coexistence of chronic microvascular complications, which also affect the bone marrow blood vessel. In uncontrolled diabetic patients, there is high prevalence of vitamin D deficiency and hyperparathyroidism leading to osteoporosis. Aims: To study the effect of diabetic control and complications on Bone mineral density in type 2 diabetes patients. Methods: A total 100 type-2 diabetic patients were enrolled from Nehru Hospital, B.R.D. Medical College, Gorakhpur during the study period from Jan-2017 to Dec -2017. All the patients were subjected to detailed clinical history, examination and investigations. Patient’s clinical profile, HbA1C, urine microscopy, fundus examination, NCV, BMD, vitamin D, PTH and various other relevant factors were measured in all patients. Result: The prevalence of osteopenia and osteoporosis were more in uncontrolled diabetic patients as compared to those in whom blood sugar was controlled. In uncontrolled diabetic group, the prevalence of abnormal BMD was more in patients with microvascular complications as compare to those who had no chronic complications of diabetes. The microvascular complications further lead to worsening of BMD due to increased PTH and low level of vitamin D by vicious cycle. Conclusions: Diabetic patients who had poor control of blood sugar level are more prone to develop microvascular complications along with osteoporosis. In poorly controlled diabetic patients there is increased prevalence of raised PTH and low vitamin D levels, which further worsen blood sugar control and osteoporosis.
Keywords: T2DM, Microvascular complications, BMD, PTH, vitamin D.
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