Effect of Childhood Type 1 Diabetes on Bone Health: Is Abnormal Bone Development During Childhood Related to Increased Fracture Risk?

Type 1 diabetes (T1D) is associated with multiple micro and macrovascular complications, with guidelines available on early screening and management. There has been growing interest in diabetes-related bone disease and fracture risk in adults with T1D. However, there is a paucity of knowledge on the effect of T1D on bone health in growing children and adolescents. Also, pathogenesis underlying diabetes-related bone disease is yet to be fully understood. Chapter 1 summarises the hypotheses and aims of our study. Chapter 2 is a review of the literature and provides the background to the study. It briefly summarises the known microvascular complications of T1D and the potential mechanisms involved in diabetes-related bone disease. It also describes the current knowledge of bone health in T1D with a particular focus on children and adolescents. Chapter 3 presents a cross-sectional study describing bone mineral density and structure in adolescents with T1D. It also describes the fracture rate and physical activity of adolescents in the study. The study explores associations between the various diabetes-related characteristics, microvascular complications and bone parameters. Chapter 4 presents future directions and potential areas of research in the field