Abstract
Diabetes mellitus and bone fragility are very prevalent disorders that affect a substantial proportion of the world population. Multiple epidemiological studies show that bone fragility is a characteristic complication of patients with type 1 or 2 diabetes. Prolonged exposure to a diabetic environment leads to changes in bone metabolism and impaired bone microarchitecture through a variety of mechanisms at the molecular and structural level. Impaired bone quality is a unique feature of diabetes-related bone fragility. Its pathophysiological mechanisms are complex and poorly understood. Measurement of bone mineral density may underestimate the risk of fracture in these patients, particularly those with type 2 diabetes, and the development of new diagnostic tools may be necessary. Here, we review the current knowledge of factors involved in diabetic bone disease, the impact of antidiabetic drugs on the risk of fracture, and the efficacy of antiosteoporotic drugs in this population.
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