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Review
. 2022 Nov 11;66(5):633-641.
doi: 10.20945/2359-3997000000552.

Diabetes and bone

Iana Mizumukai de Araújo  1 , Mariana Lima Mascarenhas Moreira  1 , Francisco José Albuquerque de Paula  2
Affiliations
Review

Diabetes and bone

Iana Mizumukai de Araújo et al. Arch Endocrinol Metab. .

Abstract

Globally, one in 11 adults has diabetes mellitus of which 90% have type 2 diabetes. The numbers for osteoporosis are no less staggering: 1 in 3 women has a fracture after menopause, and the same is true for 1 in 5 men after the age of 50 years. Aging is associated with several physiological changes that cause insulin resistance and impaired insulin secretion, which in turn lead to hyperglycemia. The negative balance between bone resorption and formation is a natural process that appears after the fourth decade of life and lasts for the following decades, eroding the bone structure and increasing the risk of fractures. Not incidentally, it has been acknowledged that diabetes mellitus, regardless of whether type 1 or 2, is associated with an increased risk of fracture. The nuances that differentiate bone damage in the two main forms of diabetes are part of the intrinsic heterogeneity of diabetes, which is enhanced when associated with a condition as complex as osteoporosis. This narrative review addresses the main parameters related to the increased risk of fractures in individuals with diabetes, and the mutual factors affecting the treatment of diabetes mellitus and osteoporosis.

Keywords: FRAX; Glucose; diagnosis; fracture; insulin.

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Conflict of interest statement

Disclosure: no potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Mechanisms involved in bone fragility in T2DM. AGEs: advanced glycosylation end products.
Figure 2
Figure 2. Different options to evaluate bone microstructure (HRpQCT, bone histomorphometry and TBS), strength (BMSi) and metabolism (biochemical markers).
See this image and copyright information in PMC

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