Bone Abstracts

Objective: Using DXA, we have previously reported that children with type 1 diabetes (T1D) had short and thin bones (Bone, 2015). Calcium supplementation promotes bone mass accrual with sustained benefit observed using milk/milk-based calcium but not calcium salts. To investigate effect of 1-year supplementation with milk vs pharmacological calcium salt on bone mineral density (BMD) and geometryin Indian underprivileged children with T1D. Both groups received vitamin D supplements.

Methodology: Design: Open label randomized control trial (Pune, India). Children with T1D with disease duration >1yr without co-morbidities were included and randomized to:Group A-1000IU vitamin D+200ml of milk, Group B-1000IU vitamin D+oral calcium carbonate 500 mg/day for 12 months (absorbable calcium ≈ 50 mg, both groups). Baseline and endline clinical, diet, physical activity and biochemical data were recorded. Bone mineral content (BMC), BMDand bone geometry were measured using iDXA (Lunar-GE) and pQCT (subset, n=30) (XCT2000, Stratec Inc.).

Results: Of 145 children, 136 completed the study. At baseline and endline children were comparable (age-12.3±3.7 yrs vs 12.6±4.1 yrs, HbA1c- 10.5±2.2% vs 10±2% respectively in Group A and B). Sunlight exposure, diet and activity were similar at baseline and endline within and between groups. There was significant improvement in serum calcium, phosphorous, alkaline phosphatase, vitamin D in both groups (P<0.05).TBLH BMC, lean mass and THLH BMD increased (percentage increase) by 16.7±16.3 vs 18.6±26.6, 13.2±12.5 vs 13.6±21.2, 8.1±9.9 vs 8.1±10.5 in Group A and B respectively with no significant difference between groups. LS BMAD increased from −0.26±0.03 to 0.28±0.04 in group A and −0.25±0.02 to 0.27±0.04 in Group B, however, there were no differences in percentage increase between groups (P>0.05). There was also significant increase in most tibial & radial pQCT based parameters but there were no differences in observed increases in both groups.

Conclusion: Milk and calcium carbonate administered together with vitamin D resulted in increases in both DXA and pQCT measured BMC, BMD and bone geometry, however, there was no difference in increase between the groups. Results of the follow-up study will inform if observed increments in DXA & pQCT measured parameters persist after discontinuation of supplements.

Disclosure: The authors declared no competing interests.