Bone remodelling and responsiveness to mechanical stimuli in individuals with type 1 diabetes mellitus.

Lay Summary

In a healthy adult, the body’s skeleton self-repairs — or remodells — itself to maintain its strength about every three to five years. At the microscopic level, this process is orchestrated by cells, called osteocytes, which can sense and respond to local mechanical forces. Recent studies have suggested that type 1 diabetes mellitus (T1DM), a metabolic bone disease, may negatively impact this mechanically regulated process and reduce bone strength. To investigate this further, we utilised novel methods to monitor local changes in bone microstructure over time using high-resolution peripheral quantitative computed tomography, allowing us to study the results of cellular behaviour on bone remodelling in participants over time. Our study found that bone formation was 47% lower and bone resorption was 59% lower in participants with T1DM compared to controls. Bone formation correlated positively with peripheral nerve function and negatively with glycemic control in participants with T1DM. Further, the links between mechanical forces acting on bone remodelling were 34% weaker for formation and 18% weaker for resorption compared to controls. Our findings show that bone remodelling in people with T1DM is in a state of low responsiveness to mechanical stimuli, resulting in impaired bone formation and resorption rates, and ultimately, impaired self-repair.

Recommended citation: Walle M, Duseja A, Whittier DE, Vilaca T Paggiosi M, Eastell R, Müller R, Collins CJ. Bone remodelling and responsiveness to mechanical stimuli in individuals with type 1 diabetes mellitus. Journal of Bone and Mineral Research https://doi.org/10.1093/jbmr/zjad014