Grant: Project Grant

Children with type 1 diabetes (T1D) have a high risk of bone fractures but it is unknown why. We hypothesize that bone development is impaired in children with T1D, making bone structure weaker. This is important as development of weaker bones can contribute to bone fragility across the lifespan. The proposed Canadian Bone Strength Development Study aims to test if bone development is impaired in children with T1D by comparing their bone development to that of healthy peers over the critical years of growth. This study also aims to discover measures influencing bone development (such as physical activity, nutrition, hormones) to guide the design of therapies to optimize bone development in children with T1D. We will recruit female (ages 10-11) and male children (ages 11-12), including 208 children with type 1 diabetes (T1D group), from four Pediatric Diabetes Clinics (Calgary, Ottawa, Saskatoon and Toronto). We will also recruit 208 healthy children (control group). We will invite children to three annual follow-up visits to assess bone development during the pubertal growth spurt. We will measure bone strength, structure and density development with fine detail using high-resolution peripheral quantitative computed tomography. We will also measure growth (height and body mass), maturity, body composition and muscle strength. We will record hormones and growth factors from blood samples taken in the clinic and monitor nutrition and physical activity. We will compare bone development between T1D and control groups and explore measures (such as physical activity and hormones) related to bone development. Findings will inform how and why bone strength development differs in children with T1D and why fracture risk is higher in childhood and later life in individuals with T1D. Importantly, findings will guide interventions aiming to optimize bone strength development in children with T1D and improve lifelong prevention of fractures.