Building Strong Foundations: Bone Health in Pediatric Patients with Diabetes

Pediatricians should promote lifestyle modifications to optimize bone health for all patients with diabetes, including ensuring adequate nutrition (vitamin D and calcium intake), exercise, and glycemic control. Dual-energy x-ray absorptiometry (DXA) scan should be considered for any patient with diabetes and a history of clinically significant fracture (vertebral fracture, low impact long-bone fracture, or multiple fractures). Referral to an endocrinologist with experience in osteoporosis treatment is appropriate for any patient with diabetes and a history of pathologic fracture.