Although insulin-dependent diabetes mellitus has been associated with decreased bone mineral density (BMD), there have been conflicting reports about the BMD in non—insulin-dependent diabetes mellitus (NIDDM): some authors report elevated BMD, some report decreased BMD, and others report unchanged BMD.1,2 We hypothesized that the variations in BMD in patients with NIDDM might be explained by differences in both the endogenous and exogenous insulin status of the subjects in each study.
Based on this hypothesis, we investigated the relationship of BMD to insulin treatment as well as endogenous insulin secretion in 144 Japanese patients with NIDDM (61 men and 83 women, mean [SD] age, 59.3 [12.2] years). Eighty-six patients were taking insulin for more than 1 year; in these patients, the insulin dosage was defined as that given at the time of BMD measurement. A BMD of L2-4 was measured with dual-energy x-ray absorptiometry (QDR-4500, Hologic Co, Waltham, Mass), as