Type 2 diabetes mellitus and fracture risk.

摘要: Increased fracture risk, traditionally associated with type 1 diabetes, has lately been of great concern in patients 2 diabetes. A variable increase risk reported, ranging from 20% to 3-fold, depending on skeletal site, diabetes duration and study design. Longer disease duration, the presence diabetic complications, inadequate glycemic control, insulin use increased for falls are all reported risk. Patients display a unique phenotype either normal or more frequently increased, bone mineral density impaired structural geometric properties. Recently, alterations material properties seem be predominant defect leading fragility. Accumulation advanced glycation end-products changes collagen cross-linking along suppression turnover significant factors impairing strength. FRAX score underestimate lumbar spine BMD is predicting vertebral fractures. Anti-diabetic medications, apart thiazolidinediones, appear safe skeleton, although data needed. Optimal strategies reduce fragility yet determined.