Osteoporosis in patients with diabetes mellitus.
Demographic trends with longer life expectancy and a lifestyle characterized by low physical activity and high-energy food intake contribute to an increasing incidence of diabetes mellitus and osteoporosis. Diabetes mellitus is a risk factor for osteoporotic fractures. Patients with recent onset of type 1 diabetes mellitus may have impaired bone formation because of the absence of the anabolic effects of insulin and amylin, whereas in long-standing type 1 diabetes mellitus, vascular complications may account for low bone mass and increased fracture risk. Patients with type 2 diabetes mellitus display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. Strategies to improve BMD and to prevent osteoporotic fractures in patients with type 1 diabetes mellitus may include optimal glycemic control and aggressive prevention and treatment of vascular complications. Patients with type 2 diabetes mellitus may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls.
Hofbauer
Lorenz C
LC
Division of Gastroenterology and Endocrinology, Department of Medicine, Philipps-University, Marburg, Germany. lorenz.hofbauer@uniklinikum-dresden.de
Brueck
Carolin C
CC
Singh
Shiv K
SK
Dobnig
Harald
H
D000328:Adult; D015519:Bone Density; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology; D010641:Phenotype; D012307:Risk Factors