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Bone disease in diabetes mellitus

Lesley D Hordon, MD
Section Editors
David M Nathan, MD
Marc K Drezner, MD
Deputy Editor
Jean E Mulder, MD


The association between diabetes mellitus and osteoporosis remains controversial [1]. 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) [2].

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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Literature review current through: Dec 2017. | This topic last updated: Apr 03, 2017.
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