![]() It is well-recognized that patients with type 2 diabetes mellitus (T2D) are at an increased risk for fractures despite normal or relatively higher BMD ( 1– 3). Also in men with T2D, an A1c ≥7% is associated with low bone turnover. The significance between groups persisted even after adjusting for medications and duration of diabetes.Ĭonclusion: An analysis across our entire study population showed a breakpoint A1c level of 7% or greater is associated with lower bone turnover. An analysis of men with T2D (n = 94) showed relatively lower OC (p=0.001) and CTx (p=0.002) in those with A1c ≥7% compared to those with <7%, respectively. A comparison of bone turnover markers revealed relatively lower OC (p = 0.002) and CTx (p = 0.0002) in group IV (A1c ≥7%), compared to the other groups. Results: Threshold model and nonlinear regression showed an A1c cut-off of 7.0, among all choices of A1cs, yields the least sum of squared errors. Threshold models were fit to the data using nonlinear regression and group comparisons among the different A1c categories performed by ANOVA. Patients were grouped into 4 categories based of A1c (group I: <6%, group II: 6.0–6.4%, group III: 6.5–6.9%, and group IV: ≥7%). The following data were obtained: A1c by HPLC, testosterone and estradiol by LC/MS, bone turnover markers Osteocalcin, C-terminal telopeptide, and sclerostin by ELISA, and BMD by DXA. Method: A cross-sectional analysis of baseline data was obtained from 217 men, ages 35–65, regardless of the presence or absence of hypogonadism or T2D, who participated in 2 clinical trials. The purpose of our study is to identify a hemoglobin A1c (A1c) threshold level by which reduction in bone turnover begins in men with T2D. Although the mechanism for bone fragility in T2D patients is multifactorial, whether glycemic control is important in generating this impairment in bone metabolism remains unclear. 5Biomedical Research Institute of New Mexico, Albuquerque, NM, United Statesīackground: Emerging data suggest that type 2 diabetes mellitus (T2D) is associated with an increased risk for fractures despite relatively normal or increased bone mineral density (BMD).4Research Service Line, New Mexico VA Health Care System, Albuquerque, NM, United States.3Division of Endocrinology, University of New Mexico, Albuquerque, NM, United States.DeBakey VA Medical Center, Houston, TX, United States 1Division of Endocrinology Diabetes and Metabolism, Baylor College of Medicine, Houston, TX, United States.Villareal 1,2 Reina Armamento-Villareal 1,2* doi:10.3389/ Joad 1 Elliot Ballato 1,2 FNU Deepika 1,2 Giulia Gregori 1,2 Alcibiades Leonardo Fleires-Gutierrez 1,2 Georgia Colleluori 1 Lina Aguirre 3,4 Rui Chen 1,2 Vittoria Russo 1 Virginia Carolina Fuenmayor Lopez 1,2 Clifford Qualls 4,5 Dennis T. GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects. Zhao X, Wang M, Wen Z, Lu Z, Cui L, Fu C, et al. Pharmacological treatment of hyperglycemia in type 2 diabetes. Nutrition considerations for the growing population of older adults with diabetes. National Library of Medicine: Medline Plus. Hypoglycemia in older people - a less well recognized risk factor for frailty. ![]() ![]() Hypoglycemia (low blood sugar).Ībdelhafiz AH, Rodríguez-Mañas L, Morley JE, Sinclair AJ. Classification and diagnosis of diabetes: Standards of Care in Diabetes-2023. Why Does Aging Increase A1c?Įl Sayed NA, Aleppo G, Aroda VR, et al. Older Adults: Standards of Care in Diabetes-2023. Generally accepted chart of blood sugar levels by age.Įl Sayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Diabetes: Monitoring your blood sugar.ĭiabetes UK. ![]() doi:10.1136/bmj.k1497.Ĭenters for Disease Control and Prevention. Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 20: population based study. Xu G, Liu B, Sun Y, Du Y, Snetselaar LG, Hu FB, et al. National diabetes statistics report 2020. doi:10.1161/CIRCRESAHA.118.312806.Ĭenters for Disease Control and Prevention. Age-Related Changes in Glucose Metabolism, Hyperglycemia, and Cardiovascular Risk. ![]()
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