REVIEW article
Front. Endocrinol.
Sec. Bone Research
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1595228
Research Progress of Diabetic Osteoporosis: A Comprehensive Review
Provisionally accepted
Xun Ma1
Xiaoqian Zhang2*- 1Shandong Second Medical University, Weifang, China
- 2Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
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Diabetic osteoporosis (DOP) is a complex metabolic bone disorder characterized by impaired bone quality and increased fracture risk in patients with diabetes mellitus.The interplay between hyperglycemia, insulin resistance, and bone metabolism underscores the need for integrated therapeutic strategies that address both glycemic control and bone health. This review systematically examines the molecular mechanisms of glucose-lowering and bone-protective agents, highlighting their dual roles in managing DOP. We discuss the pathophysiological pathways underlying DOP, including insulin/IGF-1 deficiency, advanced glycation end products (AGEs) accumulation, oxidative stress, and vascular damage. Furthermore, we explore the mechanisms of action of antidiabetic drugs (e.g., metformin, GLP-1 receptor agonists, SGLT2 inhibitors) and anti-osteoporotic agents (e.g., bisphosphonates, teriparatide, strontium ranelate), emphasizing their potential synergies and risks. Finally, we outline future directions for developing novel therapeutics and optimizing combination therapies to achieve dual metabolic and skeletal benefits in DOP patients.
Keywords: Diabetic osteoporosis, Pathophysiological mechanisms, Glucose-lowering agents, Anti-osteoporotic Agents, Traditional Chinese Medicine
Received: 17 Mar 2025; Accepted: 17 Aug 2025.
Copyright: © 2025 Ma and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoqian Zhang, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong Province, China
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