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This cross-sectional study analyzed bone mineral density (BMD) in children and adolescents with type 1 diabetes mellitus (DM1) and its relationship with metabolic control, duration of disease and bone markers.Forty-four children and adolescents with DM1 (age 8.8+/-4.4 years, disease duration 6.6+/-3.9 years) and 22 healthy children were assessed for BMD of the lumbar spine (L1-L4) by dual energy X-ray absorptiometry; osteocalcin (OC) and carboxy-terminal telopeptide (CTX) were measured in the study group.The BMD was similar in subjects with (-1.15+/-1.2 S.D.) and without DM1 (-0.85+/-0.88 S.D., p=0.25). After adjustment for weight, height and pubertal development, the BMD was-2.0 S.D. in only two diabetic patients (4.5%). Bone area (BA) was inversely correlated with the duration of diabetes (p=0.03) and HbA1c (p=0.02). In girls, who presented a worse HbA1c than boys (p0.01), BMD was inversely correlated with HbA1c (p=0.05). OC and CTX levels were higher in boys (p0.01) and both inversely correlated with pubertal development (p=0.01), but not with BMD.Children and adolescents with DM1 have normal bone mass in the lumbar spine. However, longer diabetes duration and poor metabolic control may have a negative impact on bone mass, requiring further investigation through longitudinal studies.