Assessment and treatment of osteoporosis and fractures in type 2 diabetes

Angela Sheu; Jerry R Greenfield; Christopher P White; Jacqueline R Center

doi:10.1016/j.tem.2022.02.006

Assessment and treatment of osteoporosis and fractures in type 2 diabetes

Trends Endocrinol Metab. 2022 May;33(5):333-344. doi: 10.1016/j.tem.2022.02.006. Epub 2022 Mar 17.

Authors

Angela Sheu¹, Jerry R Greenfield², Christopher P White³, Jacqueline R Center⁴

Affiliations

¹ Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia. Electronic address: a.sheu@garvan.org.au.
² Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, Australia.
³ Clinical School, Prince of Wales Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Metabolism, Prince of Wales Hospital, Sydney, Australia.
⁴ Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales Sydney, Sydney, Australia; Department of Endocrinology and Diabetes, St Vincent's Hospital, Sydney, Australia.

PMID: 35307247
DOI: 10.1016/j.tem.2022.02.006

Abstract

There is substantial, and growing, evidence that type 2 diabetes (T2D) is associated with skeletal fragility, despite often preserved bone mineral density. As post-fracture outcomes, including mortality, are worse in people with T2D, bone management should be carefully considered in this highly vulnerable group. However, current fracture risk calculators inadequately predict fracture risk in T2D, and dedicated randomised controlled trials identifying optimal management in patients with T2D are lacking, raising questions about the ideal assessment and treatment of bone health in these people. We synthesise the current literature on evaluating bone measurements in T2D and summarise the evidence for safety and efficacy of both T2D and anti-osteoporosis medications in relation to bone health in these patients.

Keywords: bone; diabetes; fractures; medications; osteoporosis; treatment.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Bone Density
Bone and Bones
Diabetes Mellitus, Type 2* / complications
Fractures, Bone* / etiology
Humans
Osteoporosis* / drug therapy
Osteoporosis* / etiology