title: Diabetes and osteoporosis: Action of gastrointestinal hormones on the bone.
abstract: A 62-year-old woman consulted for evaluation of treatment for her type 2 diabetes diagnosed four years ago. He had been received treatment with metformin 850mg twice, with no chronic associated complications. She had hypertension and dyslipidemia. She was being treated with candesartan/hydrochlorothiazide 32/12.5mg and atorvastatin 40mg. Her weight was 92kg and height 162cm (BMI, 35.1kg/m(2)). The last analysis showed fasting glucose 168mg/dl and glycated hemoglobin 7.5%, Microalbuminuria was negative. Blood pressure and lipid profile were within the therapeutic range. Two years ago she suffered a nontraumatic Colle's fracture in her left arm for which she was taking a daily calcium and vitamin D supplement and weekly alendronate. In summary, this is an obese female patient with type 2 diabetes mellitus and inadequate metabolic control, She also has a history of fragility fracture. How should this patient be evaluated and treated?
authors.affiliation: Unidad de Metabolismo Óseo, Servicio de Endocrinología, Hospital Universitario San Cecilio, Granada, España; Sección de Endocrinología, Hospital Comarcal del Noroeste, Murcia, España. Electronic address: garciamartin_t@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: García-Martín
authors.affiliation: Unidad de Metabolismo Óseo, Servicio de Endocrinología, Hospital Universitario San Cecilio, Granada, España; Unidad de Endocrinología, Hospital General Universitario Rafael Méndez, Murcia, España.
authors.forename: R
authors.initials: R
authors.lastname: Reyes-García
authors.affiliation: Servicio de Medicina Interna, Hospital La Inmaculada, Almería, España.
authors.forename: J M
authors.initials: JM
authors.lastname: García-Castro
authors.affiliation: Unidad de Metabolismo Óseo, Servicio de Endocrinología, Hospital Universitario San Cecilio, Granada, España.
authors.forename: M
authors.initials: M
authors.lastname: Muñoz-Torres
keywords: Diabetes mellitus tipo 2; Gastrointestinal hormones; Hormonas gastrointestinales; Osteoporosis; Type 2 diabetes mellitus