Vol 59, No 3 (2008)
Review paper
Published online: 2008-05-08
Does type 2 diabetes predispose to osteoporotic bone fractures?
Endokrynol Pol 2008;59(3):224-229.
Abstract
Chronic complications of diabetes are associated mainly with changes in major and small arterial vessels as well as in peripheral and
autonomic fibers of the nervous system. For years it has been suggested that DM2 does not predispose to osteoporosis because bone
mineral density (BMD) in DM2 patients is commonly normal or even increased. However, results of recent large cross-sectional studies
have indicated that patients with DM2 have significantly increased risk of bone fractures, predominantly hip fractures (by 70%). Results of
these studies suggest that the increased risk of fractures in DM2 is independent of BMD. In this group of patients is frequently associated
the loss of vision caused by diabetic eye disease, peripheral neuropathy, arterial hypertension, orthostatic hypotonia (caused by autonomic
neuropathy or/and by concomitant antihypertensive treatment), and ischemic disease of the brain, heart and lower extremities
- conditions that predispose to falls. There are no specific methods of prophylaxis and treatment of osteoporosis associated with diabetes;
therefore they should be based on widely accepted principles as in non-diabetic populations. It seems that in DM2 patients the most
purposeful strategy could be the popularization of healthy attitudes aiming the elimination of unfavorable dietetic and environmental
factors, such as low physical activity, smoking, and low vitamin D intake, as well as education against falls.
Keywords: diabetesosteoporosisbone mineral density
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