title: [Diabetes and osteoporosis: pathophysiological interactions and clinical importance for geriatric patients].
abstract: Osteoporosis is an age-associated disease, resulting in impaired bone quality and increased risk for bone fractures. Patients with type 2 diabetes mellitus have--despite a normal or even increased bone mineral density--an increased risk for fractures, which is related to an imbalance between osteoblastic bone formation and osteoclastic resorption. Complex pathophysiological mechanisms associated with insulin resistance and hyperglycemia are involved in the deleterious effects on osteoblast function and bone formation. The quality and regimen of antidiabetic therapy are discussed as modulators of bone metabolism. Of great clinical importance is an assessment of the fall risk especially for diabetic patients, because late complications, such as neuropathy, but also side effects of medication can result in a significantly increased risk for falls. Lifestyle intervention is of advantage with respect to diabetes and osteoporosis prevention and therapy. Vitamin D supplementation results in favorable effects with a reduced risk for falls and also improvements of insulin sensitivity. According to published data, the safety and efficacy of specific medication for the treatment of osteoporosis (bisphosphonates, denosumab, selective estrogen receptor modulators) reveal no difference between patients with and without diabetes mellitus.
authors.affiliation: Abteilung für Innere Medizin, Landeskrankenhaus Hochzirl, Anna-Dengel Haus, 6170, Zirl, Österreich. monika.lechleitner@tilak.at
authors.forename: M
authors.initials: M
authors.lastname: Lechleitner
authors.forename: K
authors.initials: K
authors.lastname: Pils
authors.forename: R
authors.initials: R
authors.lastname: Roller-Wirnsberger
authors.forename: E
authors.initials: E
authors.lastname: Beubler
authors.forename: R
authors.initials: R
authors.lastname: Gasser
authors.forename: P
authors.initials: P
authors.lastname: Mrak
authors.forename: F
authors.initials: F
authors.lastname: Hoppichler
authors.forename: P
authors.initials: P
authors.lastname: Pietschmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D040242:Risk Reduction Behavior; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D007004:Hypoglycemic Agents; D014807:Vitamin D