Diabetes mellitus, either type 1 (T1DM) or type 2 (T2DM), is associated with increased bone fragility. Fracture incidence among diabetic patients is higher than in nondiabetic individuals, fracture risk being highest in T1DM. Clinical factors that possibly contribute to diabetes-associated bone fragility are age of onset and disease duration, presence of microvascular complications, and some antidiabetic drugs that may affect bone strength or increase the risk of hypoglycemia and therefore falls. Changes in bone mineral density, which is relatively reduced in T1DM and normal or even increased in T2DM, cannot entirely explain the increase in fracture risk associated with diabetes. Both T1DM and T2DM are characterized by reduced bone turnover (both formation and resorption), which may affect bone quality. Alterations in bone matrix, such as increased formation of advanced glycation end products, may also reduce bone quality. Glucotoxicity, increased oxidative stress, and inflammation are common findings in diabetes, but their impact on bone fragility is unclear. Strategies to prevent fractures in diabetes include tackling known modifiable risk factors and using antiosteoporotic medications, which have been proved equally effective and safe in diabetics.

Diabetes and bone

Conte, Caterina;
2019-01-01

Abstract

Diabetes mellitus, either type 1 (T1DM) or type 2 (T2DM), is associated with increased bone fragility. Fracture incidence among diabetic patients is higher than in nondiabetic individuals, fracture risk being highest in T1DM. Clinical factors that possibly contribute to diabetes-associated bone fragility are age of onset and disease duration, presence of microvascular complications, and some antidiabetic drugs that may affect bone strength or increase the risk of hypoglycemia and therefore falls. Changes in bone mineral density, which is relatively reduced in T1DM and normal or even increased in T2DM, cannot entirely explain the increase in fracture risk associated with diabetes. Both T1DM and T2DM are characterized by reduced bone turnover (both formation and resorption), which may affect bone quality. Alterations in bone matrix, such as increased formation of advanced glycation end products, may also reduce bone quality. Glucotoxicity, increased oxidative stress, and inflammation are common findings in diabetes, but their impact on bone fragility is unclear. Strategies to prevent fractures in diabetes include tackling known modifiable risk factors and using antiosteoporotic medications, which have been proved equally effective and safe in diabetics.
2019
9780128148419
Diabetes complications
Fractures
Prediabetes
Type 1 diabetes
Type 2 diabetes
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12078/5994
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