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Diabetes and bone health
Authors:Marianna Antonopoulou  Gül Bahtiyar  Mary Ann Banerji  Alan S Sacerdote
Institution:1. SUNY Downstate Medical Center, United States;2. Woodhull Medical Center, NYU School of Medicine, United States
Abstract:The increasing prevalence of diabetes especially type 2 diabetes worldwide is indisputable. Diabetics suffer increased morbidity and mortality, compared to their non-diabetic counterparts, not only because of vascular complications, but also because of an increased fracture incidence. Both types 1 and 2 diabetes and some medications used to treat it are associated with osteoporotic fractures. The responsible mechanisms remain incompletely elucidated. In this review, we evaluate the role of glycemic control in bone health, and the effect of anti-diabetic medications such as thiazolidinediones, sulfonylureas, DPP-4 inhibitors, and GLP-1 agonists. In addition, we examine the possible role of insulin and metformin as anabolic agents for bone. Lastly, we identify the current and future screening tools that help evaluate bone health in diabetics and their limitations. In this way we can offer individualized treatment, to the at-risk diabetic population.
Keywords:AGEs  advanced glycation endproducts  BMD  bone mineral density  CAH  congenital adrenal hyperplasia  DM  diabetes mellitus  DPP-4  dipeptydil petptidase-4  DXA  dual-energy X-ray absorptiometry  FRAX  fracture risk assessment tool  FSH  follicle stimulating hormone  GH  growth hormone  GIP  gastric inhibitory polypeptide  GLP  glucagon like peptide  IGFBP3  insulin-like growth factor binding protein 3  IGF-1  insulin like growth factor 1  LH  luteinizing hormone  PCOS  polycystic ovarian syndrome  PPAR-gamma agonists  peroxisome proliferator-activated receptor gamma  SHBG  sex hormone binding globulin  PTH  parathyroid hormone  TZDs  thiazolidinediones
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