Bone Disease

Kendall Moseley, M.D., Todd T. Brown, M.D., Ph.D.
Bone Disease is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Osteoporosis and low bone density/osteopenia are the most important bone diseases observed in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), characterized by decreased bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fracture.
  • On bone density measurements via dual energy X-ray absorptiometry (DXA): a T-score between +1.0 and -1.0 standard deviations (SD) is considered normal bone density, a score between -1.0 to -2.5 SD is low bone density/osteopenia, and a score equal to or below -2.5 SD is osteoporosis; Z-scores are used for men < 50 years and pre menopausal women.
  • Osteomalacia is softening of the bone resulting from impaired bone mineralization with calcium, vitamin D, and phosphorus.
  • Charcot foot is a result of bone loss in the foot or ankle causing microfractures, ligament laxity and bony destruction, exacerbated by neuropathy and patient’s inability to perceive ongoing trauma.

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Last updated: January 12, 2015