Bone histomorphometry in diabetes mellitus

Excerpt

Diabetes mellitus (DM) is a common disease with many complications; recently, one more complication has been associated with DM, an increased risk of fragility fractures [1‐3]. Both type 1 and type 2 diabetes patients display an increase in bone fragility, which appears to be somewhat independent of bone mineral density (BMD) [4]. In fact, type 2 diabetes (T2D) patients have, in general, normal BMD while type 1 patients (T1D) have low BMD, which may contribute to fracture risk, but does not fully account for it [5, 6]. In this regard, a study analyzing bone material strength (BMS) using microindentation testing in vivo, demonstrated that postmenopausal women with T2D had lower BMS, and therefore compromised bone material properties, which were negatively correlated with glycated hemoglobin [7]. This suggests that the excess fracture risk in diabetes may be related to poor bone quality, raising questions regarding bone structure, material properties, and remodeling activity in these patients. In addition, poor glucose control and hypoglycemia besides other features related to the diabetic patient such as impaired vision and balance due to retinopathy and neuropathy increase fall and fracture risk. [8]. …