Brief Answer: You need complete physical examination by doctor. Detailed Answer: Hi, I have read your query. You have mentioned history of insulin dependent diabetes, atrophy and osteoporosis. One I want to clear you that type 1 diabetes has long been associated with low bone density because Insulin-like growth factors and other cytokines may influence diabetic bone metabolism. So for this you have to get your physical examination done by doctor who then, advise you some form of drugs with muscle strengthening regime. I usually advise least 1,200 mg/day of elemental calcium and 400–800 IU/day of vitamin D to all my patients who have osteoporosis. In addition supplements, food, and juices can all be good sources of calcium. After doing your physical examination your doctor may advise you bone mineral density (BMD) obtained via dual x-ray absorptiometry (DXA) as is the most common standard tool for bone mass assessment. I usually recommend bisphosphonates (BPNs) to my patients as numerous clinical trials showing marked improvement in osteoporosis. My patients are also very happy after using bisphosphonates. Your doctor may advise you androgen replacement therapy, Salmon calcitonin. After your complete physical examination and above mentioned investigations your doctor may advise you certain exercise regime and medication. Avoid smoking, drinking alcohol, caffeine as much as you can. Your doctor may advise you some muscle strengthening exercise regime for atrophy. For pain management in your case you should consult your doctor regarding medications include 1 mg of hydromorphone 4 times daily for chronic pain secondary to osteoporosis and loxapine as needed if needed. Also once your osteoporosis get treated your pain automatically will go away. Al-last I would like to say that, you should not treat yourself own your own without consulting any doctor because only your doctor would decide best combination of treatment for you by doing your physical examination and by seeing your report of investigations. I hope you have got your answer. You are welcome to ask further health related queries. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: WWW.WWWW.WW Let me know if you have any concerns. Thanks. Dr.Singh.

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