{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:04:28Z","timestamp":1767863068723,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>The bone mineral density in patients with type 1 diabetes mellitus is reduced due to impaired insulin secretion. However, it is unclear whether the rate of bone mineral density reduction is affected by the type 1 diabetes mellitus subtype. This study aimed to clarify the difference in bone mineral density across type 1 diabetes mellitus subtypes: slowly progressive (SP), acute\u2010onset (AO), and fulminant (F).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, single\u2010center, cross\u2010sectional study conducted on 98 adult type 1 diabetes mellitus patients. The main outcome included the bone mineral density Z\u2010score (BMD\u2010Z) measured at the lumbar spine and femoral neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The lumbar spine BMD\u2010Z was lower in the acute\u2010onset than in the slowly progressive subtype (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). No differences were observed when compared with the fulminant subtype. The femoral neck BMD\u2010Z tended to be higher in the slowly progressive than in the acute\u2010onset and fulminant subtypes. Multiple regression analyses showed that the lumbar spine BMD\u2010Z was associated with subtypes (AO vs SP) (<jats:italic>P<\/jats:italic>\u2009=\u20090.01), but not subtypes (F vs SP), adjusted for sex, duration, retinopathy, and C\u2010peptide immunoreactivity (CPR). When the patients were divided into disease duration tertiles, in the first and second tertiles, the CPR levels were lower in the acute\u2010onset or fulminant than in the slowly progressive subtype. In contrast, the lumbar spine and femoral neck BMD\u2010Z differed between the acute\u2010onset and slowly progressive only in the second tertiles (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), with a similar tendency between the fulminant and slowly progressive subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among the type 1 diabetes mellitus subtypes, bone mineral density undergoes time\u2010dependent changes, which reveals that the bone mineral density decline follows the impaired insulin secretion. These results provide novel insights into the association between the low insulin exposure duration and bone mineral density.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13817","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T03:33:20Z","timestamp":1650944000000},"page":"1585-1595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Relation between the insulin lowering rate and changes in bone mineral density: Analysis among subtypes of type 1 diabetes mellitus"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-7828","authenticated-orcid":false,"given":"Masaki","family":"Suzuki","sequence":"first","affiliation":[{"name":"Division of Diabetes and Endocrinology Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe 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