About the PhD thesis

Diabetes-related osteoporosis is a lesser-known complication of type 1 diabetes. Previous clinical and epidemiological studies have shown decreased bone turnover and bone mineral density (BMD) as well as impaired microstructure and accumulation of advanced glycation end-products (AGEs) in individuals with type 1 diabetes.

The aim of this thesis is to characterize the bones of adults with type 1 diabetes, investigate the relationship between muscle and bone in individuals with type 1 diabetes, and discuss whether risk factors such as autonomic neuropathy and accumulation of AGEs may pre-dict low bone quality in type 1 diabetes.

The above is elucidated through clinical studies. The results contrib-ute to describing a type 1 diabetes bone phenotype by confirming a microstructural difference between bones in individuals with and with-out type 1 diabetes. The volumetric mineral density in trabecular bone was decreased in individuals with type 1 diabetes. In addition, decreased cortical bone thickness was observed in the distal radius and tibia. Muscle mass and strength were positively correlated with bone mineral density in both individuals with and without type 1 diabetes, and no differences in muscle mass and strength were ob-served between groups. Finally, the results showed that higher levels of AGE accumulation measured by skin autofluorescence were asso-ciated with lower BMD and trabecular bone score (TBS) and could potentially contribute to the overall assessment of fracture risk in indi-viduals with type 1 diabetes.