Osteoporosis: An Under-appreciated Complication of Diabetes

• Published in: Diabetes care Vol. 22; no. 1; p. 10
• Main Authors: Sue A. Brown, Julie L. Sharpless, Y E Granfeldt, I E Björck, N G Asp, B O Vessby
• Format: Journal Article
• Language: English
• Published: American Diabetes Association 01-01-1999; 01-01-2004
• ISSN: 0149-5992; 0891-8929; 1945-4953; 1935-5548
• DOI: 10.2337/diaclin.22.1.10

Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic
patients.
A E Järvi ,
B E Karlström ,
Y E Granfeldt ,
I E Björck ,
N G Asp and
B O Vessby
Clinical Nutrition Research Unit, Uppsala University, Sweden. [e-mail]
Abstract
OBJECTIVE: To evaluate the effects of varying the glycemic index (GI) of carbohydrate-rich foods on metabolic control in type
2 diabetic patients. RESEARCH DESIGN AND METHODS: In a randomized crossover study, 20 patients, 5 women and 15 men, were given
preweighed diets with different GIs during two consecutive 24-day periods. Both diets were composed in accordance with dietary
recommendations for people with diabetes. The macronutrient composition and type and amount of dietary fiber were identical.
Differences in GI were achieved mainly by altering the structure of the starchy foods. RESULTS: Peripheral insulin sensitivity
increased significantly and fasting plasma glucose decreased during both treatment periods. There was a significant difference
in the changes of serum fructosamine concentrations between the diets (P < 0.05). The incremental area under the curve for
both blood glucose and plasma insulin was approximately 30% lower after the low- than after the high-GI diet. LDL cholesterol
was significantly lowered on both diets, with a significantly more pronounced reduction on the low-GI diet. Plasminogen activator
inhibitor-1 activity was normalized on the low-GI diet, (-54%, P < 0.001), but remained unchanged on the high-GI diet. CONCLUSIONS:
A diet characterized by low-GI starchy foods lowers the glucose and insulin responses throughout the day and improves the
lipid profile and capacity for fibrinolysis, suggesting a therapeutic potential in diabetes.
Osteoporosis: An Under-appreciated Complication of Diabetes
Sue A. Brown , MD and
Julie L. Sharpless , MD
Abstract
In Brief
Care of patients with diabetes should include an assessment of bone health. It is now clear that patients with type 1 diabetes
have lower bone mineral density (BMD) and higher risk of fractures. Evidence is accumulating that patients with type 2 diabetes
who have complications are also at increased risk of certain types of osteoporotic fractures despite having a higher BMD when
compared to patients with type 1 diabetes. Therapeutic interventions are key to preventing fractures, both by improving bone
density and decreasing the risk for falls.
Footnotes
Sue A. Brown, MD, and Julie L. Sharpless, MD, are assistant professors of medicine in the Division of Endocrinology at the
University of North Carolina, Chapel Hill.
American Diabetes Association