Middle-aged premenopausal women with type 1 diabetes have lower bone mineral density and calcaneal quantitative ultrasound than nondiabetic women. Diabetes Care 29

OBJECTIVE — To determine whether middle-aged premenopausal women with type 1 dia-betes had more self-reported fractures and lower bone mineral density (BMD) compared with nondiabetic women. RESEARCH DESIGN AND METHODS — Participants were premenopausal women aged 35–55 years with type 1 diabetes (n 67; 32.2 5.3 years duration) and without diabetes (n 237). Total hip, femoral neck, whole-body, and spine BMD were measured by dual X-ray absorptiometry. Calcaneal broadband ultrasound attenuation (BUA) was assessed with quanti-tative ultrasound. RESULTS — Women with type 1 diabetes were more likely to report a fracture after age 20 years compared with nondiabetic women (33.3 vs. 22.6%; age-adjusted odds ratio 1.89 [95 % CI 1.02–3.49]). Type 1 diabetes was associated with lower total hip BMD (0.890 vs. 0.961 g/cm2; P 0.001), femoral neck BMD (0.797 vs. 0.847 g/cm2; P 0.001), whole-body BMD (1.132 vs. 1.165 g/cm2; P 0.01), and lower calcaneal BUA (71.6 vs. 84.9 dB/MHz; P 0.001) after multivariate adjustment. BMD was 3–8 % lower in type 1 diabetic compared with control women and calcaneal BUA was 15 % lower. Spine BMD and biomarkers of bone remodeling were no