Skip to main content

01-20-2018 | Osteoporosis | Article

Comparison of osteoporosis in US adults with type 1 and type 2 diabetes mellitus

Journal of Endocrinological Investigation

Authors: S. C. DeShields, T. D. Cunningham

Publisher: Springer International Publishing



We examined bone mineral density (BMD) and osteoporosis prevalence in those with type 1 compared to type 2 diabetes derived from a nationally representative sample from the civilian community in the United States.


Data from the National Health and Nutrition Examination Survey (NHANES) for 2005–2006, 2007–2008, 2009–2010, and 2013–2014 were merged to obtain a large sample of diabetics at least 20 years of age with participation in the interview and medical examination. Osteoporosis status was defined by BMD at the total femur, femoral neck, or total lumbar spine. Self-reported diabetics that were prescribed insulin within the first year of diagnosis, are currently taking insulin, and reported no prescriptions for any diabetic pills were classified as type 1. Remaining self-reported diabetics were deemed as having type 2.


A total of 2050 diabetics were included in which 87 (4%) were classified as type 1. Type 1 diabetics were found to have a significantly lower BMD at the total femur and femoral neck, but not at the lumbar spine in the adjusted models. Diabetics with type 1 were 4.7 times more likely to have osteoporosis than those with type 2. There was no significant relationship between diabetes type and BMD or osteoporosis prior to adjustment for confounders.


Although our results show an increased likelihood of osteoporosis among those with type 1 diabetes, future studies including a larger sample from a community population are needed. It may benefit diabetics, especially those with type 1, to initiate osteoporosis screening methods including evaluation of fracture risk, bone quality, and BMD measurements at multiple sites earlier than recommended.

Please log in to get access to this content

Related topics

Why nurses make the difference for diabetes

Learn more about the 2020 World Diabetes Day theme.

DiRECT: Type 2 diabetes remission through weight management

Primary findings, 2-year outcomes and translating this landmark trial into practice

Image Credits