Osteoporosis and type 2 diabetes mellitus: what do we know, and what we can do?

Abstract

Diabetes mellitus (DM) is a pandemic and chronic metabolic disorder with substantial morbidity and mortality. In addition, osteoporosis (OP) is a silent disease with a harmful impact on morbidity and mortality. Therefore, this systematic review focuses on the relationship between OP and type 2 diabetes mellitus (T2DM). Systematic reviews of full-length articles published in English from January 1950 to October 2010 were identified in PubMed and other available electronic databases on the Universiti Sains Malaysia Library Database. The following keywords were used for the search: T2DM, OP, bone mass, skeletal. Studies of more than 50 patients with T2DM were included. Forty-seven studies were identified. The majority of articles (26) showed increased bone mineral density (BMD), while 13 articles revealed decreased BMD; moreover, eight articles revealed normal or no difference in bone mass. There were conflicting results concerning the influence of T2DM on BMD in association with gender, glycemic control, and body mass index. However, patients with T2DM display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. As a conclusion, screening, identification, and prevention of potential risk factors for OP in T2DM patients are crucial and important in terms of preserving a good quality of life in diabetic patients and decreasing the risk of fracture. Patients with T2DM may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls. Patient education about an adequate calcium and vitamin D intake and regular exercise is important for improving muscle strength and balance. Furthermore, adequate glycemic control and the prevention of diabetic complications are the starting point of therapy in diabetic patients.

Bone Mineral Density in Relation to Metabolic Syndrome Components in Postmenopausal Women With Diabetes Mellitus Type 2

“…Many studies investigated the relationship between T2DM and bone metabolism, but their results were inconsistent. For patients with T2DM, some authors have reported increased BMD, others have reported decreased BMD, and some have reported unaltered BMD 16 . Th e aim of this study was to investigate the relationship between components of the metabolic syndrome, central adiposity and hyperinsulinemia, as well as infl ammation markers with vertebral and femoral BMD and bone turnover markers in postmenopausal women with T2DM.…”

Does Osteoporosis with Type 2 Diabetes Mellitus (Diabetoporosis) increase the risk of fracture?

“…Although the relationship between type 2 diabetes and osteoporosis has been broadly studied, some details remain controversial [9]. Type 2 diabetes could influence bone metabolism through many mechanisms [10]. Studies regarding the association between Type 2 diabetes and bone quality showed different results: some studies reported that diabetes increased BMD [11], while others reported that it either decreased [12] or did not affect the BMD in patients with osteoporosis [13].…”

A Review of the Mechanisms, Diagnosis and Preventative Treatment of Osteoporotic Fragility Fractures in Patients With Type 2 Diabetes Mellitus

“…Type 2 diabetes mellitus (T2DM), although considered a disease of glucose regulation, is associated with wide-ranging derangement of metabolic and vascular homeostasis [3]. Worldwide approximately 382 million people have diabetes, 3.2 million of whom are in the UK, of which 90% have type 2 [4,5].…”

“…Similarly, obesity and a sedentary lifestyle can affect balance, gait and co-ordination. Any combination of these can lead to an increased falls risk [3,10,11]. However, even in studies that controlled for fall frequency, T2DM remained independently associated with higher fragility fracture risk [6].…”