Fracture Risk Assessment in Diabetes

Chapter

Abstract

As highlighted in earlier chapters, diabetes mellitus is associated with an increased risk for low-trauma fractures [1, 2]. In the case of Type 1 diabetes (T1DM) this is at least partially mediated through lower bone mineral density (BMD) as reflected by routine clinical measurements such as dual energy X-ray absorptiometry (DXA) [2]. The situation with Type 2 diabetes (T2DM) is clearly more complicated since BMD measurements are typically increased. In view of the differences in underlying pathophysiology and how this may mediate its effects on subsequent fractures, it is unlikely that a single approach for fracture risk assessment will be equally applicable to T1DM and T2DM. Given the preponderance of T2DM among older individuals, the segment of the population at highest risk for osteoporotic fractures, and the BMD-fracture paradox alluded to earlier, this chapter will emphasize considerations in T2DM.

Keywords

Diabetes Osteoporosis Fracture Bone mineral density Dual-energy x-ray absorptiometry 
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Notes

Disclosures

WDL (all fees paid to facility): Speaker bureau: Amgen, Eli Lilly, Novartis. Research grants: Amgen, Genzyme. SH: None.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Medicine (C5121)University of ManitobaWinnipegCanada
  2. 2.Division of Endocrinology, Department of MedicineTygerberg (deceased) Academic Hospital, Stellenbosch UniversityCape TownSouth Africa

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