TYPE 2 DIABETES MELLITUS AND THE EFFECTS OF LIFESTYLE ON BONE MINERAL DENSITY IN PRE-AND POSTMENOPAUSAL WOMEN

There are controversies on the effects of diabetes and lifestyle of affected patients on their bone mineral densities (BMDs). This study has investigated the effects of lifestyle of type 2 diabetics on BMD at the lumbar spine and proximal femur in pre and postmenopausal women. In a historical cohort study, 20 pre-menopausal type 2 diabetics and 57 non-diabetics and 126 type 2 Diabetics and 315 non-diabetics postmenopausal women, were recruited. BMD measurements were also made to the spine and proximal femur (Neck, Wards, and Shaft) by dual energy X-ray absorptiometry (DXA) technique. Exclusion criteria were endocrine, rheumatologic or chronic diseases. Type 2 diabetic cases and non-diabetics were matched for age and body mass index (BMI) in both pre menopausal or postmenopausal groups. A total of 146 type 2 Diabetic patients without any other endocrine disorder and 372 non-diabetic women, aged 40-81 years were enrolled. No significant differences were found between diabetics and healthy controls in terms of BMD values of spine and femur regions in the pre‌menopausal women. Postmenopausal diabetics, however, had higher BMD at the lumbar spine compared with the healthy postmenopausal controls. An age-related decrease in BMD values (lumbar and femur) was observable in all groups and a significant correlation between BMI and BMD was found. Adjusting for age and BMI, the effect of lifestyle on BMD at all sites was investigated. Occupation was associated with BMD in postmenopausal, but not in premenopausal women. Among the investigated dietary items, milk, yogurt and cheese were all associated with increased BMD in at least one region in diabetic patients. Smoking was not associated with BMD. Type 2 Diabetes does not seem to be complicated by bone loss and osteoporosis. Physical activity and milk consumption in postmenopausal diabetic women can be a protective factor against bone loss.