title: Bone damage in type 2 diabetes mellitus.
abstract: This review focuses on the mechanisms determining bone fragility in patients with type 2 diabetes mellitus (T2DM). Despite bone mineral density (BMD) is usually normal or more often increased in these patients, fracture incidence is high, probably because of altered bone "quality". The latter seems to depend on several, only partly elucidated, mechanisms, such as the increased skeletal content of advanced glycation end-products causing collagen deterioration, the altered differentiation of bone osteogenic cells, the altered bone turnover and micro-architecture. Disease duration, its severity and metabolic control, the type of therapy, the presence or absence of complications, as like as the other known predictors for falls, are all relevant contributing factors affecting fracture risk in T2DM. In these patients the estimate of fracture risk in the everyday clinical practice may be challenging, due to the lower predictive capacity of both BMD and risk factors-based algorithms (e.g. FRAX).
authors.affiliation: Unit of Internal Medicine, "Casa Sollievo della Sofferenza" Hospital, IRCCS, Viale dei Cappuccini snc, 71013 San Giovanni Rotondo, FG, Italy. Electronic address: venz.carnevale@libero.it.
authors.forename: V
authors.initials: V
authors.lastname: Carnevale
authors.affiliation: Department of Experimental Medicine, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Romagnoli
authors.affiliation: Department of Internal Medicine and Medical Specialties, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: D'Erasmo
authors.affiliation: Department of Internal Medicine and Medical Specialties, "Sapienza" University, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: D'Erasmo
mesh_terms: D000058:Accidental Falls; D000465:Algorithms; D000818:Animals; D015519:Bone Density; D001842:Bone and Bones / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology*; D004195:Disease Models, Animal; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006801:Humans; D015994:Incidence; D012307:Risk Factors
chemical_list: D017127:Glycation End Products, Advanced
keywords: Bone mineral density; Bone quality; Clinical risk factors; Fractures; Type 2 diabetes mellitus