Skeletal Effects of Type 1 Diabetes on Low-Trauma Fracture Risk

The investigators will enroll 40 female, postmenopausal, patients with T1DM, fracturing or non-fracturing, who are age 50 and over, and have had diabetes for more than ten years. The investigators will perform 2 transiliac (hip bone) biopsies on each subject, one for mechanical testing, tissue analysis of AGEs, enzymatic crosslinks and bone tissue-bound water in cortical bone, and the other for histomorphometry and high-resolution 3D imaging in trabecular bone. A matched, non-diabetic, healthy control will be enrolled at the time each T1DM is enrolled.

Inclusion criteria

Criteria for enrollment of female diabetics

• No chronic disease diagnoses that may affect bone, as confirmed by the PI.
• Normal clinical history, physical, and clinical laboratory exam (except for usual complications of a 10+-year diabetic, i.e., ~minimal neuropathy or retinopathy, known, but asymptomatic mild vascular disease, etc.)
• Glomelular Filtration Rate (GFR) >45 ml/min (Renal Association lower limit for "mild" kidney failure).
• Willingness to sign a consent form.
• Willingness to undergo a transilial bone biopsy incision that yields 2 bone specimens.
• No abnormalities in clinical blood chemistry measurements (small, age-related decreases in GFR, will be permitted).
• Caucasian

Criteria for each non-diabetic subject, compared to their matched diabetic:

• Dual-energy x-ray absorptiometry (DXA) measures (BMD, gm/cm) must be within +/- 15% in total hip.
• Body mass index (BMI) must be within +/-10%.
• Age must be within +/- 5 years.
• Caucasian

Exclusion criteria

• Women who have had Type 1 diabetes for less than 10 years.
• Non-insulin dependent Type 1 diabetic.
• Less than 50 years old.
• Less than 5 years post menopausal.