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01-03-2015 | Skeletal and calcium controversies in diabetes mellitus, cardiovascular disease, and lipid disorders

Diabetes and Bone: Still a Lot to Learn

Authors: Joumana T. Chaiban, Kristine G. Nicolas

Published in: Clinical & Translational Metabolism | Issue 1/2015

Abstract

Both type 2 diabetes mellitus (T2DM) and osteoporosis are increasing worldwide. There is a large body of knowledge pointing to the association of these two diseases with a potential increased risk of falls and fractures in patients with diabetes. Whereas patients with type 1 diabetes have a low bone mineral density (BMD), those with T2DM tend to have a high BMD rendering the task difficult for clinicians to diagnose bone “weakness” and identify patients at higher risk of fractures. The duration and type of diabetes and glycemic control seem to affect fracture risk. Several underlying pathophysiologic pathways and factors are increasingly linking glucose and bone homeostasis. Factors secreted by bone such as osteocalcin and osteoprotegerin seem to affect glucose metabolism, while hyperglycemia, insulin and advanced glycation end products appear to disrupt bone quality. Adipocytokines, mainly leptin and adiponectin, are major players in the pathophysiology of those two diseases. Vitamin D and parathyroid hormone, the main two regulators of calcium and bone metabolism, have an important role in diabetes too. Yet, there is still some controversy surrounding few of those mechanisms and interactions. In this review, we will summarize available evidence illustrating the intimate interaction between glucose and bone homeostasis and highlight studies examining fracture and fall risk in patients with diabetes.

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Title: Diabetes and Bone: Still a Lot to Learn
Authors: Joumana T. Chaiban
Kristine G. Nicolas
Publication date: 01-03-2015
Publisher: Springer US
Published in: Clinical & Translational Metabolism / Issue 1/2015
Print ISSN: 1534-8644
Electronic ISSN: 2948-2445
DOI: https://doi.org/10.1007/s12018-015-9178-9

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