Endocrine Abstracts

Background: Diabetes and osteoporosis are both frequent conditions, a link may thus put a substantial number of patients at risk of fragility fractures and the consequences of these such as pain, disability, and increased mortality. Skeletal fragility and osteoporosis may represent a hitherto overlooked complication of diabetes in line with say diabetic eye disease, diabetic nephropathy etc.

Findings: An increased risk of fractures has been observed in both type 1 and type 2 diabetes. In type 1 diabetes, a decreased bone density has been observed, while in type 2 diabetes, bone density may actually be increased. A discrepancy seemingly exists between bone density and fracture risk in diabetes, especially in type 2 diabetes. The increase in fracture risk has been observed at the hip, spine, and forearm as well as for overall risk of fractures. Especially the risk of hip fractures seems increased in type 1 diabetes, whereas the increase is less pronounced in type 2 diabetes. Hypoglycemia seems to play a minor role for the occurrence of fractures. The increase in fracture risk seemingly is related to diabetes per se and less so to complications (say falls related to diabetic eye disease).

Conclusions: An increased risk of fractures – in particular hip fractures, which may be associated with significant excess mortality and morbidity – may be present. The increase may be linked to skeletal frailty resulting from metabolic disruptions stemming from impaired glucose metabolism rather than from falls related to hypoglycemia or say reduced eye sight.