Grant: Project Grant

Children and adults with type 1 diabetes have up to 40% more fractures than the general population. Diabetic bone fragility is believed to originate during childhood skeletal development. How bone structure, micro-architecture and strength develop in children with type 1 diabetes in comparison healthy children is, however, poorly understood. We will first study if children with type 1 diabetes develop weaker bone structure. We will also test if development of weaker bones is due to low vitamin D level in blood and/or lack of specific impact forces from physical activities. We will follow 300 boys and girls, aged 6-13 years at the beginning of study for 4 years and compare how bone micro-structure and strength develops between children with and without type 1 diabetes. We measure bone structure in fine detail at the wrist and ankle using state-of-the-art bone imaging tools safe for children. We will measure vitamin D-level using finger prick test while details of impact forces from physical activities will be measured using activity monitors. We will estimate maturity of children, measure body muscle size and record details of diet from all children and diabetes status from clinical data of diabetic children. This study will be first to reveal if, how and why diabetic children develop weaker bone structure. This study will inform us about the role of vitamin D and specific physical activities that can help to build strong bone structure in children with type 1 diabetes. Study results can be translated into interventions to optimize bone development in children with diabetes and enhance prevention of diabetic bone fragility and related fractures across the lifespan.