A narrative review of diabetic bone disease: Characteristics, pathogenesis, and treatment

Abstract

Recently, the increasing prevalence of diabetes mellitus has made it a major chronic illness which poses a substantial threat to human health. The prevalence of osteoporosis among patients with diabetes mellitus has grown considerably. Diabetic bone disease is a secondary osteoporosis induced by diabetes mellitus. Patients with diabetic bone disease exhibit variable degrees of bone loss, low bone mineral density, bone microarchitecture degradation, and increased bone fragility with continued diabetes mellitus, increasing their risk of fracture and impairing their ability to heal after fractures. At present, there is extensive research interest in diabetic bone disease and many significant outcomes have been reported. However, there are no comprehensive review is reported. This review elaborates on diabetic bone disease in the aspects of characteristics, pathogenesis, and treatment.

Keywords: bone; diabetes mellitus; diabetic bone disease; pathogenesis; treatment.

Figure 1

Pathogenesis of diabetic bone disease. The deficiency of insulin and insulin-like growth factor-1 leads to decreased bone formation in T2DM. Advanced glycation end products inhibited osteoblasts differentiation. Interleukin-6 and tumor necrosis factor α can promote the proliferation and differentiation of osteoclast precursor cells into mature osteoclasts and accelerate the process of bone resorption.