A four-year study of 200 children and adolescents with type 1 diabetes has found significant declines in bone density and structure, particularly among those with a longer disease duration. Bone mineral density Z-scores decreased from −1.4 to −1.7, while trabecular bone density fell from 167.7 to 150.2 mg/cm³ and cortical thickness declined from 3.1 to 1.8 mm. A BMD was measured using dual energy X-ray absorptiometry (DXA) for total body less head (TBLH). Key findings: Total of 200 subjects (mean age: 10.6 ± 3.9 years; diabetes duration: 3.2 ± 3.2 years) were studied for four years. Progressive deterioration of bone density and geometry in children and adolescents with type 1 diabetes: A 4-year DXA and pQCT based study.