Vijay Shivaswamy
Tanzania
Review Article
Diabetes, Bone Density, and Fractures
Author(s): Vijay Shivaswamy, Lynn Mack and Jennifer LarsenVijay Shivaswamy, Lynn Mack and Jennifer Larsen
All types of diabetes increase risk for osteoporosis and fracture due to multiple factors. Hyperglycemia itself may play a role, but frequent hypoglycemia, falls, hypogonadism, vitamin D deficiency, body mass index (BMI), and advanced complications may play an even larger role. Very low BMI in type 1 diabetes and elevated BMI in youth with type 2 diabetes can increase fracture risk, as well as visceral obesity in postmenopausal women. Those with advanced complications, such as peripheral and autonomic neuropathy, visual impairment, renal failure, and vascular disease are also at greater risk, in part due to greater risk for falls. Many medications can contribute to bone loss, but the thiazolidinediones are the only diabetes medications known to have a direct impact on bone mass, particularly in women. After transplant, immunosuppressant medications also contribute to fracture risk... View More»
