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January 21, 1983

Diabetes Mellitus and Skeletal Fracture

JAMA. 1983;249(3):353. doi:10.1001/jama.1983.03330270023018

To the Editor.—  Patients with insulin-dependent diabetes mellitus (IDD) or non-IDD can experience severe osteopenia.1-3 However, it has been claimed that the risk for fracture is not increased in patients with osteopenia secondary to diabetes mellitus.4 Contrary to this view, it has been our clinical impression that some patients with diabetes seem to have fractures with only minimal trauma, and others heal very slowly. A patient with IDD and severe osteopenia apparently caused by diabetes and multiple fractures inappropriate to the degree of trauma recently was seen by us.

Report of a Case.—  A 26-year-old man with a history of IDD since the age of 10 years and no other known diseases complained of a backache of one year's duration. His spinal roentgenograms showed a compression fracture with reduction of anterior vertical height of T-8 and T-12. Substantial osteoporosis was noted. Regional bone mass was determined with a