Of note is that insulin deficiency and insulin-like growth factor-1 (IGF-1) reduction [27, 46–48] and hyperglycaemia-induced oxidative stress and accumulation of advanced glycation end-products (AGEs) that compromise collagen properties [69, 70], low osteocalcin levels [62, 63], and/or Wnt signalling pathway [71, 72] seem to be causing these changes, resulting in a reduction in the mature osteoblast numbers and thus bone formation, leading to low peak bone mass at a young age [31–34]. Here, IGF1 is linked to Hyperglycemia.