Progression and Etiology of Cortical Porosity in Diabetic Bone Disease

Prior treatment

• Perimenopausal women, defined as last menses within previous 3 years
• Current alcohol consumption (\>3 alcohol drinks/day), current illicit drug use.
• Use of medications known to impact bone and mineral metabolism, including use of a bisphosphonate or teriparatide in the last year or for \>12 months ever, current calcitonin, prednisone \> 5mg daily or the equivalent glucocorticoid for \> 10 days in the last 3 months, current thiazolidinedione (TZD), thyroid hormone replacement with current thyroid stimulating hormone \< 0.1 miu/L. Patients undergoing hormone/testosterone replacement will NOT be excluded meaning they can be enrolled)
• Trauma or surgery near radius or tibia imaging sites
• An episode of immobilization lasting longer than 1 week in the previous 6 months

Other illness

• Conditions excluded by x-ray or MRI safety guidelines

Lab values

• History of metabolic bone disease other than post-menopausal bone loss. Persons with the following diseases: chronic gastrointestinal disease (including inflammatory bowel disease, celiac disease, or other malabsorptive disease including short-gut syndrome), renal or hepatic impairment (known cirrhosis or if transaminase levels 3 times the upper limit of normal)
• Estimated Glomerular Filtration Rate (eGFR)\< 50 mL/min/1.73 m2 (baseline) or \< 40 (follow-up). The investigators will require eGFR ≥ 50 at baseline in an effort to avoid the possibility of an enrolled subject dropping below the established safety level of 40 at follow-up. This was determined knowing that eGFR can decline at a rate of approximately 4.0 per year in diabetics (much lower in non-diabetics).

Other

• Body mass index greater than 40 as these subjects will be too large to fit into the gantry of the MR scanner or exceed weight limitations of the MR table

• Postmenopausal female and/or male
• 50-70 years old
• Body mass index (BMI) of 18-40
• Subjects with bone mineral density of: 0 ≥ T-score \> -2.5
• Additional requirement for type II diabetes patients:
  • Patients has a history of type II diabetes, as defined by the American Diabetes Association for more than 3 years. Patients must either have a documented HbA1C of 6.5 or higher for 3 or more years if they are not undergoing pharmacological treatment (diet controlled), or must have been receiving pharmacological treatment for the past 3 years.