Impact of diabetes and its treatments on skeletal diseases

Wenbo Yan, Xin Li

Research output: Contribution to journalArticle

Abstract

Diabetes mellitus is an enormous menace to public health globally. This chronic disease of metabolism will adversely affect the skeleton if not controlled. Both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) are associated with an increased risk of osteoporosis and fragility fractures. Bone mineral density is reduced in T1DM, whereas patients with T2DM have normal or slightly higher bone density, suggesting impaired bone quality is involved. Detrimental effects of T1DM on the skeleton are more severe than T2DM, probably because of the lack of osteo-anabolic effects of insulin and other pancreatic hormones. In both T1DM and T2DM, low bone quality could be caused by various means, including but not limited to hyperglycemia, accumulation of advanced glycosylation end products (AGEs), decreased serum levels of osteocalcin and parathyroid hormone. Risk for osteoarthritis is also elevated in diabetic population. How diabetes accelerates the deterioration of cartilage remains largely unknown. Hyperglycemia and glucose derived AGEs could contribute to the development of osteoarthritis. Moreover, it is recognized that oral antidiabetic medicines affect bone metabolism and turnover as well. Insulin is shown to have anabolic effects on bone and hyperinsulinemia may help to explain the slightly higher bone density in patients with T2DM. Thiazolidinediones can promote bone loss and osteoporotic fractures by suppressing osteoblastogenesis and enhancing osteoclastogenesis. Metformin favors bone formation by stimulating osteoblast differentiation and protecting them against diabetic conditions such as hyperglycemia. Better knowledge of how diabetic conditions and its treatments influence skeletal tissues is in great need in view of the growing and aging population of patients with diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)81-90
Number of pages10
JournalFrontiers of Medicine in China
Volume7
Issue number1
DOIs
StatePublished - 2013

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Type 2 Diabetes Mellitus
Type 1 Diabetes Mellitus
Hyperglycemia
Bone Density
Anabolic Agents
Osteogenesis
Bone and Bones
Skeleton
Osteoarthritis
Diabetes Mellitus
Pancreatic Hormones
Insulin
Therapeutics
Oral Medicine
Thiazolidinediones
Advanced Glycosylation End Products
Osteoporotic Fractures
Bone Remodeling
Metformin
Osteocalcin

Keywords

  • bone
  • diabetes
  • osteoarthritis
  • osteoporosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Impact of diabetes and its treatments on skeletal diseases. / Yan, Wenbo; Li, Xin.

In: Frontiers of Medicine in China, Vol. 7, No. 1, 2013, p. 81-90.

Research output: Contribution to journalArticle

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