title: The diabetic paradox: Bone mineral density and fracture in type 2 diabetes.
abstract: Type 2 diabetes mellitus prevalence and morbidity are increasing. Osteoporotic fractures are among the 'non-classical' complications of diabetes and been overlooked for a long time, maybe because of their complex diagnostic and therapeutic approach. The usual tools for preventing fragility fractures (such as the fracture risk assessment tool and bone densitometry) underestimate risk of fractures in type2 diabetic patients. New techniques, such as trabecular bone score or bone turnover markers, could be useful, but greater scientific evidence is required to recommend their use in clinical practice. The special characteristics of their pathophysiology result in decreased bone remodeling with normal or even increased bone mineral density, but with low quality. These changes lead to the occurrence of osteoporotic fractures without evidence of densitometric changes, which could be called 'the diabetic paradox'.
authors.affiliation: Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Pamplona, España. Electronic address: sony_bm@hotmail.com.
authors.forename: Sonsoles
authors.initials: S
authors.lastname: Botella Martínez
authors.affiliation: Departamento de Bioquímica, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: Nerea
authors.initials: N
authors.lastname: Varo Cenarruzabeitia
authors.affiliation: Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Escalada San Martin
authors.affiliation: Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: Amparo
authors.initials: A
authors.lastname: Calleja Canelas
mesh_terms: D000058:Accidental Falls; D015519:Bone Density; D016723:Bone Remodeling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D010024:Osteoporosis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D014808:Vitamin D Deficiency / Q000150:complications / Q000503:physiopathology
chemical_list: D007004:Hypoglycemic Agents
keywords: Bone metabolism; Diabetes mellitus; Fracture risk; Metabolismo óseo; Riesgo de fractura; Trabecular bone score