Acta Diabetologica

, Volume 55, Issue 4, pp 305–314 | Cite as

Insulin resistance and bone: a biological partnership

  • Caterina Conte
  • Solomon Epstein
  • Nicola Napoli
Review Article


Despite a clear association between type 2 diabetes (T2D) and fracture risk, the pathogenesis of bone fragility in T2D has not been clearly elucidated. Insulin resistance is the primary defect in T2D. Insulin signalling regulates both bone formation and bone resorption, but whether insulin resistance can affect bone has not been established. On the other hand, evidence exists that bone might play a role in the regulation of glucose metabolism. This article reviews the available experimental and clinical evidence on the interplay between bone and insulin resistance. Interestingly, a bilateral relationship between bone and insulin resistance seems to exist that unites them in a biological partnership.


Insulin Obesity Osteocalcin Type 2 diabetes Bone mineral density Bone turnover markers 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No studies involving human participants nor experimental animals were conducted by the authors specifically for the preparation of this article.


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© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilanItaly
  2. 2.Division of EndocrinologyMount Sinai School of MedicineNew YorkUSA
  3. 3.Division of Endocrinology and DiabetesUniversità Campus Bio-Medico di RomaRomeItaly
  4. 4.Division of Bone and Mineral DiseasesWashington University in St LouisSt LouisUSA

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