Diabetes and Bone

Excerpt

Diabetes and osteoporosis are two of the most common chronic disorders which prevalence increases worldwide, eventually affecting hundreds of millions of people. The environmental, primarily nutritional, conditions that predispose to diabetes and osteoporosis, respectively, appear quite different, but there may be some common genetic factors predisposing to both disorders. Although the morphotype of subjects developing type 2 diabetes as a consequence of overweight and the metabolic syndrome seems protective against fractures, and is certainly far from the image of the frail elderly with bone fragility, type 2 diabetes is increasingly recognized as an independent risk factor for fractures—at least in the bone community, although not yet broadly recognized as a complication of glucose impairment in the diabetes community. The risk of fragility fractures is even higher among the leaner patients with type 1 diabetes, whose long-standing disease is associated with an up to fivefold higher hip fracture risk, which incidence starts to rise 10–15 years before the exponential rise observed in the non-diabetic population. The relative contribution of decreased bone strength, in particular bone “quality,” and increased incidence of injurious falls, to the higher fracture risk among diabetics remains unknown. …