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Update on the Acute Effects of Glucose, Insulin, and Incretins on Bone Turnover In Vivo

  • Bone and Diabetes (A Schwartz and P Vestergaard, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To provide an update on the acute effects of glucose, insulin, and incretins on markers of bone turnover in those with and without diabetes.

Recent Findings

Bone resorption is suppressed acutely in response to glucose and insulin challenges in both healthy subjects and patients with diabetes. The suppression is stronger with oral glucose compared with intravenous delivery. Stronger responses with oral glucose may be related to incretin effects on insulin secretion or from a direct effect on bone turnover. Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-2 (GLP-2) infusion acutely suppresses bone resorption without much effect on bone formation. The bone turnover response to a metabolic challenge may be attenuated in type 2 diabetes, but this is an understudied area. A knowledge gap exists regarding bone turnover responses to a metabolic challenge in type 1 diabetes.

Summary

The gut-pancreas-bone link is potentially an endocrine axis. This linkage is disrupted in diabetes, but the mechanism and progression of this disruption are not understood.

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Authors and Affiliations

  1. Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Vanessa D. Sherk

  2. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Irene Schauer

  3. Rocky Mountain Regional VA Medical Center, Aurora, CO, USA

    Irene Schauer

  4. Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Viral N. Shah

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  1. Vanessa D. Sherk
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  2. Irene Schauer
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  3. Viral N. Shah
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Correspondence to Vanessa D. Sherk.

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Conflict of Interest

Viral Shah reports grants from T1D Exchange and Jaeb Center for Health Research, vTv Therapeutics, Sanofi US, Dexcom Inc., NovoNordisk, NIAMS (K23AR075099), NIDDK (1 R01 DK122554-01), Mylan GmBH, and the Juvenile Diabetes Research Foundation, outside the submitted work.

Dr. Shah is on the advisory board for Sanofi US and Dexcom Inc.

Vanessa Sherk reports grants from ASBMR (Rising Star Award) and NIH (KL2 TR002534), outside the submitted work.

Irene Schauer declares no conflict of interest.

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Sherk, V.D., Schauer, I. & Shah, V.N. Update on the Acute Effects of Glucose, Insulin, and Incretins on Bone Turnover In Vivo. Curr Osteoporos Rep 18, 371–377 (2020). https://doi.org/10.1007/s11914-020-00598-z

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