Journal
OSTEOPOROSIS INTERNATIONAL
Volume 29, Issue 12, Pages 2585-2596Publisher
SPRINGER LONDON LTD
DOI: 10.1007/s00198-018-4650-2
Keywords
Diabetes; Diabetes-related bone disease; Fracture; Osteoporosis
Categories
Funding
- MRC [G0400491, MC_UU_12011/2, MC_U147585827, MC_UP_A620_1015, MC_U147585819, MR/P020941/1] Funding Source: UKRI
- Medical Research Council [G0601019] Funding Source: researchfish
- Medical Research Council [MC_UP_A620_1015, MC_U147585824, G0400491, MR/P020941/1, MC_UU_12011/1, MC_UP_A620_1014, MC_U147585819, MC_UU_12011/2, MC_U147585827] Funding Source: Medline
- Department of Health [10/33/04] Funding Source: Medline
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Fragility fractures are increasingly recognized as a complication of both type 1 and type 2 diabetes, with fracture risk that increases with disease duration and poor glycemic control. Yet the identification and management of fracture risk in these patients remains challenging. This review explores the clinical characteristics of bone fragility in adults with diabetes and highlights recent studies that have evaluated bone mineral density (BMD), bone microstructure and material properties, biochemical markers, and fracture prediction algorithms (i.e., FRAX) in these patients. It further reviews the impact of diabetes drugs on bone as well as the efficacy of osteoporosis treatments in this population. We finally propose an algorithm for the identification and management of diabetic patients at increased fracture risk.
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