December 2, 2015

IOF Urges Early Evaluation of Fracture Risk in Patients With Diabetes

NYON, Switzerland -- December 2, 2015 -- Despite an up to 6-fold increased risk of broken bones in patients with type 1 diabetes, the relationship between diabetes and osteoporosis has, until recently, suffered from a general lack of attention and research. As a result, health professionals who treat diabetic patients often do not recognise that fragility fractures are a major complication of the disease.

In order to promote understanding of the latest advances and to encourage early evaluation of fracture risk, the International Osteoporosis Foundation (IOF) Bone and Diabetes Scientific Working Group has now published a succinct review which provides endocrinologists with valuable information in regard to fracture risk in patients with type 1 diabetes.

“Although more studies are needed, researchers have recently made encouraging progress in elucidating the complex relationship between bone and diabetes,” said Serge Ferrari, MD, Geneva University Hospital, Geneva, Switzerland. “The findings underline the need for early evaluation and fracture prevention strategies.”

Published in the European Journal of Endocrinology, the review summarises the latest knowledge on the epidemiology of fracture risk in patients with diabetes; quantitative and structural bases of bone fragility; bone turnover and the continued process of bone loss and replacement; cellular and molecular mechanisms of diabetic bone disease; evaluation and management of bone fragility in type 1 diabetes; the higher fracture risk in patients with type 1 diabetes is not only due to decreased bone mineral density, but also to alterations in bone quality.

Recent clinical studies point to impaired osteoblastic bone formation, with or without increased bone resorption. Insulin deficiency also appears to be a major pathophysiological mechanism involved, along with other metabolic alterations that may all play a role in altering bone turnover and bone quality.

As the onset of type 1 diabetes often occurs during childhood, the assessment and management of bone health in the young is of special concern. General measures to prevent osteoporosis in children with early onset of diabetes include a balanced diet with adequate calcium and vitamin D intake and, in particular, sufficient physical activity. Increasing weight-bearing exercise in children with diabetes as well as good glycaemic control appears to provide some improvement of bone parameters.

“As fragility fractures are a major complication of diabetes, fracture risk should be properly evaluated in patients with this disorder,” said Dr. Ferrari. “Research is urgently needed on the benefits and risks of osteoporosis therapy as so far none of the anti-osteoporotic agents have been tested for their anti-fracture efficacy in patients with type 1 diabetes. This is all the more reason for health professionals to focus on early evaluation and other fracture prevention strategies in their patients.”

SOURCE: International Osteoporosis Foundation (IOF)
Log in to post comments

Tell us what you think of DG News

Click to like Click to dislike