Bone disease in diabetes mellitus
- Lesley D Hordon, MD
Lesley D Hordon, MD
- Consultant in Rheumatology
- University of Leeds, United Kingdom
- Section Editors
- David M Nathan, MD
David M Nathan, MD
- Editor-in-Chief — Endocrinology
- Section Editor — Diabetes Mellitus
- Professor of Medicine
- Harvard Medical School
- Marc K Drezner, MD
Marc K Drezner, MD
- Section Editor — Bone Disease
- Professor of Medicine
- University of Wisconsin Medical School
The association between diabetes mellitus and osteoporosis remains controversial . Although the metabolic abnormalities of diabetes potentially affect bone metabolism, structure, and mineral density, the extent of their contribution to the increase in fracture risk noted in individuals with type 1 and type 2 diabetes is still debated. In addition to changes in bone metabolism, there are several other factors that may be important:
●The onset of diabetes in adolescence may result in a decreased peak bone mass.
●The degree of bone loss differs between type 1 and type 2 diabetes. In some studies, type 2 diabetes has been associated with an increase in bone mineral density (BMD) .
●Bone fragility, particularly in type 2 diabetes, may contribute to fracture risk independent of BMD, and BMD may not reflect fracture risk in some individuals.
●Bone metabolism may be affected by the late complications of diabetes (eg, renal failure).
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