MANAGEMENT OF ENDOCRINE DISEASE: Diabetes and osteoporosis: cause for concern?

Abstract

Diabetes and osteoporosis are both frequent conditions, and they may thus occur simultaneously by chance. However, a growing body of evidence suggests that hyperglycemia may impair bone matrix formation and biochemical competence. Decreased biomechanical competence may be present even in a setting of increased bone mineral density, as assessed by traditional dual energy X-ray absorptiometry or normal structural parameters by quantitative computed tomography. Also, the absence of endogenous insulin secretion in type 1 diabetes (T1D) and insulin resistance or, in some cases, frank hyperinsulinemia in T2D may play a role.

Effects of Transplanting Bone Marrow Stromal Cells Transfected with CXCL13 on Fracture Healing of Diabetic Rats

“…One reason for this was the deposition of bone collagen induced by AGEs. Then, osteoblasts can't adhere to collagen and the activities and maturation of osteoclast increased, which resulted in the decrease of BMD and maximum cross-sectional area of callus and may finally become osteoporosis [26,27]. Our study further confirmed that the bone remodeling was affected by the diabetes mellitus, contributing to the delayed fracture healing.…”

Update on Bone Health in Pediatric Chronic Disease

“…11 In the absence of insulin, there are increased levels of OPG and decreased RANKL. 32–35 Underlying microvasculopathy, decreased vitamin D levels, inflammation, and increased levels of advanced glycation end products further contribute to impaired bone health. 28,32 …”

Mechanisms involved in altered bone metabolism in diabetes: a narrative review

“…This finding is explained with lack of insulin in T1DM patients and could account for higher risk of osteopenia and osteoporosis in young age T1DMs [24]. Nevertheless higher BMD levels which have been reported in patients with T2DM in comparison with patients with T1DM could be explained by higher body weight levels and BMD in the T2DM patients [25]. …”