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Diabetes and bone - new insights into signalling mechanisms and bone quality

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Diabetes is known to have a number of complications such as atherosclerosis, nephropathy, retinopathy, and neuropathy. However, diabetes may also affect bone and compromise bone biomechanical competence beyond what is revealed through changes in bone mineral density. Bone disease may thus ne a novel hitherto ...

Diabetes is known to have a number of complications such as atherosclerosis, nephropathy, retinopathy, and neuropathy. However, diabetes may also affect bone and compromise bone biomechanical competence beyond what is revealed through changes in bone mineral density. Bone disease may thus ne a novel hitherto overlooked complication of diabetes.
Diabetes may affect bone in a number of ways: 1) glucose may affect collagen by foming advanced glycation end products (AGE) such as pentosidine, which may lower bone biomechanical competence, 2) hyperglycaemia and AGE may affect bone cells leading to a state of low bone turnover and thus osteoporosis, 3) hyperglycaemia may lead to excess loss of calcium in the urine and thus a negative calcium balance. Furthermore many differences between type 1 diabetes (T1D) and type 2 diabetes (T2D) affect bone as patients with T1D are often underweight and lack insulin, which is an anabolic factor, whereas T2D patients are often overweight, and may have high levels of insulin and insulin like growth factor. The treatment of diabetes may also affect bone as weight loss in type 2 diabetes may lead to a loss of BMD and thiazolidinediones may convert stem cells into adipocytes rather than osteoblasts and may also affect the aromatase system.
Further knowledge is thus needed on bone biomechanical competence, bone structure, bone turnover, effect of drugs and effects of diabetes control on bone.


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