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Review
. 2021 Aug 1;28(4):383-389.
doi: 10.1097/MED.0000000000000640.

Bone health in diabetes: Indian perspective

Rimesh Pal  1 , Sanjay Kumar Bhadada
Affiliations
Review

Bone health in diabetes: Indian perspective

Rimesh Pal et al. Curr Opin Endocrinol Diabetes Obes. .

Abstract

Purpose of review: Despite estimated 77 million people having diabetes, bone health in Asian Indians with diabetes is largely unknown. This review summarizes the published literature on fracture risk and factors affecting it in Asian Indians with diabetes.

Recent findings: Data on fracture prevalence in diabetes is limited; one study showed that diabetes was associated with a significantly higher number of fractures compared with subjects without diabetes (4% vs. 2.4%, P < 0.05). The prevalence of osteoporosis in Asian Indians with type 2 diabetes mellitus (T2D) varies from 35.5 to 49.5%. Studies have shown an increased, similar or lower areal bone mineral density (BMD) at the lumbar spine and/or hip in patients with T2D compared to controls without diabetes. On the contrary, the BMD in patients with type 1 diabetes mellitus (T1D) is modestly low compared to age- and sex-matched healthy controls without diabetes. Recent studies have shown compromised mechanical, material and compositional properties of trabecular bone in Asian Indians with T2D suggesting deteriorated bone quality as one of the contributors of high fracture risk.

Summary: Further research is needed to generate evidence-based guidelines to prevent and manage bone fragility in Asian Indians with diabetes.

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References

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    1. Janghorbani M, Feskanich D, Willett WC, et al. Prospective study of diabetes and risk of hip fracture: the Nurses’ Health Study. Diabetes Care 2006; 29:1573–1578.
    1. Janghorbani M, Van Dam RM, Willett WC, et al. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol 2007; 166:495–505.
    1. Shah VN, Mohan V. Diabetes in India: what is different? Curr Opin Endocrinol Diabetes Obes 2015; 22:283–289.
    1. Napoli N, Chandran M, Pierroz DD, et al. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol 2017; 13:208–219.

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