Table 1: Factors implicated in poor bone health and increased fracture risk in T1DM.

Factors causing low BMD
(1) Deficiency of insulin—loss of bone anabolic action [1]
(2) Poor glycaemic control—↑ renal calcium excretion, IGF-1/↑ IGF-BP1, acidosis, alterations in collagen, and inflammation [1, 18]
(3) Associated deficiency of other bone anabolic peptides—for example, amylin [1]
(4) Other associated autoimmune disorders like celiac disease [1]
(5) Associated hypogonadism

Factors increasing fracture risk
(1) Hypoglycemic episodes—fits and falls [1]
(2) Poor vision—retinopathy, cataracts, and so forth [1]
(3) Neurologic complications—neuropathy, cerebrovascular episodes, and so forth [1]