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Osteopenia and Metatarsal Fractures in Diabetic Neuropathy
Author(s) -
Cundy T. F.,
Edmonds M. E.,
Watkins P. J.
Publication year - 1985
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1985.tb00683.x
Subject(s) - medicine , osteopenia , metatarsal bones , diabetic neuropathy , diabetes mellitus , osteopathy , surgery , diabetic foot , endocrinology , osteoporosis , bone mineral , pathology , alternative medicine
Radiographs of the hands and feet of 19 diabetic patients with severe neuropathy were compared to those of 22 control patients without neuropathy. The two groups were matched for age, sex, and duration of diabetes. Cortical bone mass, measured by x‐ray morphometry, was significantly lower in both the hands ( p <0.002) and the feet ( p <0.001) of those with neuropathy. The osteopenia was worse in the feet than the hands and also worse in women. Serum alkaline phosphatase levels were also significantly higher in the neuropathy group ( p <0.005). Metatarsal fractures were a frequent finding in the neuropathic patients, but were not seen in controls. The presence of metatarsal fractures was strongly associated with the subsequent development of diabetic osteopathy ( p <0.001). We conclude that cortical bone mass in the feet and hands is reduced in severe diabetic neuropathy. This may contribute to the predisposition to metatarsal fracture and diabetic osteopathy.