Bone and Diabetes

  • Jakob Starup-LindeEmail author
  • Søren Gregersen
Reference work entry
Part of the Endocrinology book series (ENDOCR)


Diabetes is associated with an increased risk of fracture. Commonly used risk factors underestimate the increased fracture risk, whereas they are solid predictors in subjects without diabetes. Bone mineral density measurements which are used for diagnosis of osteoporosis underestimate the fracture risk in patients with diabetes. Diabetes is a state of low bone turnover which may contribute to increased bone fragility. The low bone turnover is likely to be due to hyperglycemia and altered incretin response. Furthermore, diabetes may glycosylate bone collagen, which may reduce bone strength. Presently no specific treatment strategy is available for diabetes in regard of the bone. Although most anti-osteoporotic treatments seem to be safe, the benefit may be less when treating a low bone turnover disease. This chapter highlights the epidemiology, mechanisms, diagnosis, and treatment of diabetic bone disease.


Type 1 diabetes Type 2 diabetes Fracture Hip fracture Vertebral fracture Hyperglycemia Bone turnover Incretins Bone mineral density Cortical porosity Diagnosis Diabetic bone disease Collagen Advanced glycosylation end products High-resolution peripheral quantitative computed tomography Comorbidities Glucose-lowering drugs Anti-osteoporotic treatment 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Endocrinology and Internal MedicineAarhus University HospitalAarhusDenmark

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