Diabetes, Metabolic Syndrome and Obesity (Dec 2019)
Type 1 Diabetes and Bone Fragility: Links and Risks
Abstract
Jakob Starup-Linde,1–3 Katrine Hygum,1 Torben Harsløf,1 Bente Langdahl1 1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; 2Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; 3Department of Medicine, Region Hospital Horsens, Aarhus, DenmarkCorrespondence: Jakob Starup-LindeDepartment of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, Aarhus N DK-8200, DenmarkTel +45 29926952Email [email protected]: Type 1 diabetes (T1D) is associated with an increased fracture risk, which is present at young and old age. Reductions in bone mineral density do not explain the increased fracture risk. Novel scanning modalities suggest that structural deficits may contribute to the increased fracture risk. Furthermore, T1D may due to insulinopenia be a state of low bone turnover. However, diabetes complications and comorbidities may influence fracture risk. Patients with T1D are fearful of falls. The diabetes related complications, hypoglycemic events, and antihypertensive treatment may all lead to falls. Thus, the increased fracture risk in T1D seems to be multifactorial, and earlier intervention with antiosteoporotic medication and focus on fall prevention is needed. This systematic review addresses the epidemiology of fractures and osteoporosis in patients with T1D and the factors that influence fracture risk.Keywords: type 1 diabetes, osteoporosis, fracture, falls, bone mineral density
