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Review Article


ScienceAsia 9 (1983): 205-222 |doi: 10.2306/scienceasia1513-1874.1983.09.205

 

CALCIUM HOMEOSTASIS AND BONE METABOLISM IN DIABETES MELLITUS

 

NATEETIP KRISHNAMRA

ABSTRACT: Diabetes mellitus is associated with bone mineral loss and increased urinary excretion of calcium and phosphate, while the reports on total plasma calcium concentrations of ionized calcium and plasma protein are inconsistent. Many hypotheses have been put forward to explain the underlying mechanism for. such changes. Osteopaenia may be a consequence of defective renal tubular reabsorption of calcium which would lead to a secondary increase in PTH secretion. On the other hand, the absence of insulin may have a direct effect on bone or osteopaenia may have resulted from inherited defects in diabetic bone. Phosphate depletion secondary to urinary loss also contributes to bone defect. Since the iPTH concentration in diabetic subjects are normal, it is likely that a primary defect in diabetic bone is responsible for diabetic osteopaenia.

     The studies of calcium metabolism in experimentally induced diabetes provide useful information. However, a distinction must be made between short and long term adaptation when considering changes in elements of calcium homeostasis.

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Faculty of Science, Department of Physiology, Mahidol University, Rama VI Rd., Bangkok 10400, Thailand

Recieved 16 August 1983