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Osteoporosis management in diabetic patient


Authors: Peter Jackuliak;  Magdaléna Kovářová;  Martin Kužma;  Zdenko Killinger;  Juraj Payer
Authors‘ workplace: V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava
Published in: Forum Diab 2021; 10(1): 17-24
Category:

Overview

Diabetes mellitus and osteoporosis are two serious civilization diseases with increasing incidence. Osteoporosis and osteoporotic fractures are already accepted as a severe co-morbidity and complications of diabetes mellitus. In management of diabetic patients is necessary to identify the high-risk group for osteoporosis and fractures, and to take appropriate preventive and therapeutic options. Available antiresorptive and osteoanabolic drug agents, which are used to treat osteoporosis, are effective also in diabetes patients. Most of the data of their effects in diabetics come only from clinical practice. But it is also necessary to achieve optimal glycemic control, with regard to the effect of antidiabetics on bone. This review provides data from clinical studies on the effect of antiporotics in diabetics as well as the effect of antidiabetics on bone.

Keywords:

antidiabetic therapy – antiresorptive therapy – diabetes mellitus – osteoporotic fracture


Sources
  1. Costantini S, Conte C. Bone health in diabetes and prediabetes. World J Diabetes 2019; 10(8): 421–445. Dostupné z DOI: <http://dx.doi.org/10.4239/wjd.v10.i8..
  2. Shah VN, Shah CS, Snell-Bergeon JK. Type 1 diabetes and risk of fracture: meta-analysis and review of the literature. Diabet Med 2015; 32(9): 1134–1142. Dostupné z DOI: <http://dx.doi.org/10.1111/dme.12734>.
  3. Dhaliwal R, Foster NC, Boyle C et al. Determinants of fracture in adults with type 1 diabetes in the USA: Results from the T1D Exchange Clinic Registry. J Diabetes Complications 2018; 32(11): 1006–1011. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jdiacomp.2018.08.016>.
  4. Vestergaard P, Rejnmark L, Mosekilde L. Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia 2005; 48(7): 1292–1299. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–005–1786–3>.
  5. Wang H, Ba Y, Xing Q et al. Diabetes mellitus and the risk of fractures at specific sites: a meta-analysis. BMJ Open 2019; 9(1): e024067. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2018–024067>.
  6. Moayeri A, Mohamadpour M, Mousavi SF et al. Fracture risk in patients with type 2 diabetes mellitus and possible risk factors: a systematic review and meta-analysis. Ther Clin Risk Manag 2017; 13: 455–468. Dostupné z DOI: <http://dx.doi.org/10.2147/TCRM.S131945>.
  7. Maurer MS, Burcham J, Cheng H. Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility. J Gerontol A Biol Sci Med Sci 2005; 60(9): 1157–1162. Dostupné z DOI: <http://dx.doi.org/10.1093/gerona/60.9.1157>.
  8. Patel S, Hyer S, Tweed K et al. Risk factors for fractures and falls in older women with type 2 diabetes mellitus. Calcif Tissue Int 2008; 82(2): 87–91. Dostupné z DOI: <http://dx.doi.org/10.1007/s00223–007–9082–5>.
  9. Picke A-K, Campbell G, Napoli N et al. Update on the impact of type 2 diabetes mellitus on bone metabolism and material properties. Endocr Connect 2019; 8(3): R55-R70. Dostupné z DOI: <http://dx.doi.org/10.1530/EC-18–0456>.
  10. [American Diabetes Association]. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes 2020. Diabetes Care 2020; 43(Suppl 1): S37-S47. Dostupné z DOI: <http://dx.doi.org/10.2337/dc20-S004>.
  11. Cummings SR, Nevitt MC, Browner WS et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 1995; 332(12): 767–773. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199503233321202>.
  12. Schwartz AV, Sellmeyer DE, Ensrud KE et al. Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab 2001; 86(1): 32–38. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem.86.1.7139>.
  13. Forsén L, Meyer HE, Midthjell K et al. Diabetes mellitus and the incidence of hip fracture: results from the Nord-Trondelag Health Survey. Diabetologia 1999; 42(8): 920–925. Dostupné z DOI: <http://dx.doi.org/10.1007/s001250051248>.
  14. Michaelsson K, Holmberg L, Mallmin H et al. Diet and hip fracture risk: a case-control study. Study Group of the Multiple Risk Survey on Swedish Women for Eating Assessment. Int J Epidemiol 1995; 24(4): 771–782. Dostupné z DOI: <http://dx.doi.org/10.1093/ije/24.4.771>.
  15. Ferrari SL, Abrahamsen B, Napoli N et al. Diagnosis and management of bone fragility in diabetes: an emerging challenge. Osteoporos Int 2018; 29(12): 2585–2596. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–018–4650–2>.
  16. Leslie WD, Aubry-Rozier B, Lamy O et al. TBS (trabecular bone score) and diabetes-related fracture risk. J Clin Endocrinol Metab 2013; 98(2): 602–609. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2012–3118>.
  17. Ebrahimpur M, Sharifi F, Nezhad FA et al. Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program. J Diabetes Metab Disord 2019; 18(1): 99–106. Dostupné z DOI: <http://dx.doi.org/10.1007/s40200–019–00395–1>.
  18. Jackuliak P, Kužma M, Killinger Z et al. Good long-term glycemic compensation is associated with better trabecular bone score in postmenopausal women with type 2 diabetes. Physiol Res 2019; 68(Suppl 2): S149-S156. Dostupné z DOI: <http://dx.doi.org/10.33549/physiolres.934304>.
  19. Schwartz AV, Vittinghoff E, Bauer DC et al. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA 2011; 305(21): 2184–2192. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2011.715>.
  20. Leslie WD, Rubin MR, Schwartz AV et al. Type 2 diabetes and bone. J Bone Miner Res 2012; 27(11): 2231–2237. Dostupné z DOI: <http://dx.doi.org/10.1002/jbmr.1759>.
  21. Giangregorio LM, Leslie WD, Lix LM et al. FRAX underestimates fracture risk in patients with diabetes. J Bone Miner Res 2012; 27(2): 301–308. Dostupné z DOI: <http://dx.doi.org/10.1002/jbmr.556>.
  22. Keegan TH, Schwartz AV, Bauer DC et al. Effect of alendronate on bone mineral density and biochemical markers of bone turnover in type 2 diabetic women: the fracture intervention trial. Diabetes Care 2004; 27(7): 1547–1553. Dostupné z DOI: <http://dx.doi.org/10.2337/diacare.27.7.1547>.
  23. Cummings SR, Black DM, Thompson DE et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998; 280(24): 2077–2082. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.280.24.2077>.
  24. Dagdelen S, Sener D, Bayraktar M. Influence of type 2 diabetes mellitus on bone mineral density response to bisphosphonates in late postmenopausal osteoporosis. Adv Ther 2007; 24(6): 1314–1320. Dostupné z DOI: <http://dx.doi.org/10.1007/BF02877778>.
  25. Inoue D, Muraoka R, Okazaki R et al. Efficacy and Safety of Risedronate in Osteoporosis Subjects with Comorbid Diabetes, Hypertension, and/or Dyslipidemia: A Post Hoc Analysis of Phase III Trials Conducted in Japan. Calcif Tissue Int 2016; 98(2): 114–122. Dostupné z DOI: <http://dx.doi.org/10.1007/s00223–015–0071–9>.
  26. Johnell O, Kanis JA , Black DM et al. Associations Between Baseline Risk Factors and Vertebral Fracture Risk in the Multiple Outcomes of Raloxifene Evaluation (MORE) Study. J Bone Miner Res 2004; 19(5): 764–772. Dostupné z DOI: <http://dx.doi.org/10.1359/JBMR.040211>.
  27. Hirano T. Pathophysiology of Diabetic Dyslipidemia. J Atheroscler Thromb 2018; 25(9): 771–782. Dostupné z DOI: <http://dx.doi.org/10.5551/jat.RV17023>.
  28. Jialal I, Singh G. Management of diabetic dyslipidemia: An update. World J Diabetes 2019; 10(5): 280–290. Dostupné z DOI: <http://dx.doi.org/10.4239/wjd.v10.i5.280>.
  29. Schwartz AV, Pavo I, Jahangir Alam J et al. Teriparatide in patients with osteoporosis and type 2 diabetes. Bone 2016; 91: 152–158. Dostupné z DOI: <http://dx.doi.org/10.1016/j.bone.2016.06.017>.
  30. Langdahl BL, Silverman S, Fujiwara S et al. Real-world effectiveness of teriparatide on fracture reduction in patients with osteoporosis and comorbidities or risk factors for fractures: Integrated analysis of 4 prospective observational studies. Bone 2018; 116: 58–66. Dostupné z DOI: <http://dx.doi.org/10.1016/j.bone.2018.07.013>.
  31. Cummings SR, San Martin J, McClung MR et al. Denosumab for Prevention of Fractures in Postmenopausal Women with Osteoporosis. N Engl J Med 2009; 361(8): 756–765. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0809493>.
  32. Zebaze R, Libanati C, McClunget MR al. Denosumab Reduces Cortical Porosity of the Proximal Femoral Shaft in Postmenopausal Women With Osteoporosis. J Bone Miner Res 2016; 31(10): 1827–1834. Dostupné z DOI: <http://dx.doi.org/10.1002/jbmr..
  33. Napoli N, Pannacciulli N, Vittinghoff E et al. Effect of denosumab on fasting glucose in women with diabetes or prediabetes from the FREEDOM trial. Diabetes Metab Res Rev 2018; 34(4): e2991. Dostupné z DOI: <http://dx.doi.org/10.1002/dmrr.2991>.
  34. Ferron M, Wei J, Yoshizawa T et al. Insulin signaling in osteoblasts integrates bone remodeling and energy metabolism. Cell 2010; 142(2): 296–308. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cell.2010.06.003>.
  35. Schwartz AV, Schafer AL, Greyet A et al. Effects of antiresorptive therapies on glucose metabolism: results from the FIT, HORIZON-PFT, and FREEDOM trials. J Bone Miner Res 2013; 28(6): 1348–1354. Dostupné z DOI: <http://dx.doi.org/10.1002/jbmr.1865>.
  36. Fard MK, Aminorroaya A, Kachuei A et al. Alendronate improves fasting plasma glucose and insulin sensitivity, and decreases insulin resistance in prediabetic osteopenic postmenopausal women: A randomized triple-blind clinical trial. J Diabetes Investig 2019; 10(3): 731–737. Dostupné z DOI: <http://dx.doi.org/10.1111/jdi.12944>.
  37. Hayakawa N, Suzuki A. Diabetes mellitus and osteoporosis. Effect of antidiabetic medicine on osteoporotic fracture. Clin Calcium 2012; 22(9): 1383–1390.
  38. Jackuliak P, Kuzma M, Payer J. Effect of antidiabetic treatment on bone. Physiol Res 2019; 68(Suppl 2): S107-S120. Dostupné z DOI: <http://dx.doi.org/10.33549/physiolres.934297>.
  39. Paul TV, Thomas N. Impact of oral antidiabetic agents on bone metabolism. Indian J Med Res 2015; 141(4): 385–388. Dostupné z DOI: <http://dx.doi.org/10.4103/0971–5916.159244>.
  40. McCarthy AD, Cortizo AM Sedlinsky C. Metformin revisited: Does this regulator of AMP-activated protein kinase secondarily affect bone metabolism and prevent diabetic osteopathy. World J Diabetes 2016; 7(6): 122–133. Dostupné z DOI: <http://dx.doi.org/10.4239/wjd.v7.i6.122>.
  41. Gilbert MP, Pratley RE. The Impact of Diabetes and Diabetes Medications on Bone Health. Endocr Rev 2015; 36(2): 194–213. Dostupné z DOI: <http://dx.doi.org/10.1210/er.2012–1042>.
  42. Majumdar SR, Leslie WD, Lix LM et al. Longer Duration of Diabetes Strongly Impacts Fracture Risk Assessment: The Manitoba BMD Cohort. J Clin Endocrinol Metab 2016; 101(11): 4489–4496. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2016–2569>.
  43. Yavropoulou M, Mousiolis A, Kolokouri V et al. Anti-diabetic treatment as an additional factor in a FRAX based evaluation of osteoporotic fracture risk. Endocrine Abstracts 2015; 37: EP300. Dostupné z DOI: <http://dx.doi.org/10.1530/endoabs.37.EP300>.
  44. Schwartz AV. Diabetes and Metabolism of Bone. In: Danoff A (ed). ENDO 2017: Meet-The-Professor Endocrine Case Management. Endocrine Society: Washington, DC 2017: 63–65. ISBN 978–1879225329.
  45. Palermo A, D‘Onofrio L, Eastell R et al. Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review. Osteoporos Int 2015; 26(8): 2073–2089. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–015–3123–0>.
  46. Lecka-Czernik B. Safety of Anti-Diabetic Therapies on Bone. Clinical Rev Bone Miner Metab 2013; 11(1): 49–58. Dostupné z DOI: <http://dx.doi.org/10.1007/s12018–012–9129–7>.
  47. Molinuevo MS, SchurmanL, McCarthy AD et al. Effect of metformin on bone marrow progenitor cell differentiation: In vivo and in vitro studies. J Bone Miner Res 2010; 25(2): 211–221. Dostupné z DOI: <http://dx.doi.org/10.1359/jbmr.090732>.
  48. Sundararaghavan V, Mazur MM, Evans B et al. Diabetes and bone health: latest evidence and clinical implications. Ther Adv Musculoskelet Dis 2017; 9(3): 67–74. Dostupné z DOI: <http://dx.doi.org/10.1177/1759720X16687480>.
  49. Melton LJ, Leibson CL, Achenbach SJ et al. Fracture risk in type 2 diabetes: update of a population-based study. J Bone Miner Res 2008; 23(8): 1334–1342. Dostupné z DOI: <http://dx.doi.org/10.1359/jbmr.080323>.
  50. Russo GT, Giandalia A, Romeo EL et al. Fracture Risk in Type 2 Diabetes: Current Perspectives and Gender Differences. Int J Endocrinol 2016; 2016: 1615735. Dostupné z DOI: <http://dx.doi.org/10.1155/2016/1615735>.
  51. Monami M, Cresci B, Colombini A et al. Bone fractures and hypoglycemic treatment in type 2 diabetic patients: a case-control study. Diabetes Care 2008; 31(2): 199–203. Dostupné z DOI: <http://dx.doi.org/10.2337/dc07–1736>.
  52. Lapane KL, Yang S, Brown MJ et al. Sulfonylureas and risk of falls and fractures: a systematic review. Drugs Aging 2013; 30(7): 527–547. Dostupné z DOI: <http://dx.doi.org/10.1007/s40266–013–0081–0>.
  53. Mehta S, Teigland C, Kfuri A et al. Comparative Safety of Oral Antidiabetic Therapy on Risk of Fracture in Patients with Diabetes. In: American Diabetes Association Scientific Sessions 2014; 165-OR. Dostupné z WWW: <https://professional.diabetes.org/meeting/scientific-sessions/74th-scientific-sessions-2014>.
  54. TuckerME. Medscape Sulfonylureas May Up Fracture Risk in Diabetes, Along With TZDs. 2014. Dostupné z WWW: <https://www.medscape.com/viewarticle/826774>.
  55. Berberoglu Z, Yazici AC, Demirag NG. Effects of rosiglitazone on bone mineral density and remodelling parameters in Postmenopausal diabetic women: a 2-year follow-up study. Clin Endocrinol (Oxf) 2010; 73(3): 305–312. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1365–2265.2010.03784.x>.
  56. Mieczkowska A, Baslé MF, Chappard D et al. Thiazolidinediones induce osteocyte apoptosis by a G protein-coupled receptor 40-dependent mechanism. J Biol Chem 2012; 287(28): 23517–23526. Dostupné z DOI: <http://dx.doi.org/10.1074/jbc.M111.324814>.
  57. Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ 2009; 180(1): 32–39. Dostupné z DOI: <http://dx.doi.org/10.1503/cmaj.080486>.
  58. Fukunaga T, Zou W, Rohatgi N et al. An Insulin-Sensitizing Thiazolidinedione, Which Minimally Activates PPARγ, Does Not Cause Bone Loss. J Bone Miner Res 2015; 30(3): 481–488. Dostupné z DOI: <http://dx.doi.org/10.1002/jbmr.2364>.
  59. Ceccarelli E, Guarino EG, Merlotti D et al. Beyond Glycemic Control in Diabetes Mellitus: Effects of Incretin-Based Therapies on Bone Metabolism. Front Endocrinol (Lausanne) 2013; 4(73). Dostupné z DOI: <http://dx.doi.org/10.3389/fendo.2013.00073>.
  60. Monami M, Dicembrini I, Antenore A et al. Dipeptidyl peptidase-4 inhibitors and bone fractures: a meta-analysis of randomized clinical trials. Diabetes Care 2011; 34(11): 2474–2476. Dostupné z DOI: <http://dx.doi.org/10.2337/dc11–1099>.
  61. Nauck MA, Del Prato S, Meier JJ et al. Dapagliflozin Versus Glipizide as Add-on Therapy in Patients With Type 2 Diabetes Who Have Inadequate Glycemic Control With Metformin: A randomized, 52-week, double-blind, active-controlled noninferiority trial. Diabetes Care 2011; 34(9): 2015–2022. Dostupné z DOI: <http://dx.doi.org/10.2337/dc11–0606>.
  62. List JF, Woo V, Morales E et al. Sodium-Glucose Cotransport Inhibition with Dapagliflozin in Type 2 Diabetes. Diabetes Care 2009; 32(4): 650–657. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08–1863>.
  63. Ljunggren Ö, Bolinder J, Johansson L et al. Dapagliflozin has no effect on markers of bone formation and resorption or bone mineral density in patients with inadequately controlled type 2 diabetes mellitus on metformin. Diabetes Obes Metab 2012; 14(11): 990–999. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1463–1326.2012.01630.x>.
  64. Kohan DE, Fioretto P, Tang W et al. Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control. Kidney Int 2014; 85(4): 962–971. Dostupné z DOI: <http://dx.doi.org/10.1038/ki.2013.356>.
  65. Watts NB, Bilezikian JP, Usiskin K et al. Effects of Canagliflozin on Fracture Risk in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab 2016; 101(1): 157–166. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2015–3167>.
  66. Campos Pastor MM, López-Ibarra PJ, Escobar-Jiménez F et al. Intensive insulin therapy and bone mineral density in type 1 diabetes mellitus: a prospective study. Osteoporos Int 2000; 11(5): 455–459. Dostupné z DOI: <http://dx.doi.org/10.1007/s001980070114>.
  67. Fowlkes JL, Clay Bunn R, Thrailkill KM. Contributions of the Insulin/Insulin-Like Growth Factor-1 Axis to Diabetic Osteopathy. J Diabetes Metab 2011; 1(Suppl). Dostupné z DOI: <http://dx.doi.org/10.4172/2155–6156.S1–003>.
  68. Zhukouskaya VV, Shepelkevich AP, Chiodini I. Bone Health in Type 1 Diabetes: Where We Are Now and How We Should Proceed. Adv Endocrin 2014; 2014: ID 982129. Dostupné z DOI: <https://doi.org/10.1155/2014/982129>.
  69. Kanazawa I, Yamaguchi T, Yamamoto M et al. Relationships between serum adiponectin levels versus bone mineral density, bone metabolic markers, and vertebral fractures in type 2 diabetes mellitus. Eur J Endocrinol 2009; 160(2): 265–273. Dostupné z DOI: <http://dx.doi.org/10.1530/EJE-08–0642>.
  70. Chandran M. Diabetes Drug Effects on the Skeleton. Calcif Tissue Int 2017; 100(2):133–149. Dostupné z DOI: <http://dx.doi.org/10.1007/s00223–016–0203-x>.
  71. Ferrari S. Diabetes and Bone. Calcif Tissue Int 2017; 100(2): 107–108. Dostupné z DOI: <http://dx.doi.org/10.1007/s00223–017–0234-y>.
  72. Quandt SA, Stafford JM, Bell RA et al. Predictors of Falls in a Multiethnic Population of Older Rural Adults With Diabetes. J Gerontol A Biol Sci Med Sci 2006; 61(4): 394–398. Dostupné z DOI: <http://dx.doi.org/10.1093/gerona/61.4.394>.
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