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Fracture Risk Assessment in Diabetes

  • Chapter
Diabetic Bone Disease

Abstract

As highlighted in earlier chapters, diabetes mellitus is associated with an increased risk for low-trauma fractures [1, 2]. In the case of Type 1 diabetes (T1DM) this is at least partially mediated through lower bone mineral density (BMD) as reflected by routine clinical measurements such as dual energy X-ray absorptiometry (DXA) [2]. The situation with Type 2 diabetes (T2DM) is clearly more complicated since BMD measurements are typically increased. In view of the differences in underlying pathophysiology and how this may mediate its effects on subsequent fractures, it is unlikely that a single approach for fracture risk assessment will be equally applicable to T1DM and T2DM. Given the preponderance of T2DM among older individuals, the segment of the population at highest risk for osteoporotic fractures, and the BMD-fracture paradox alluded to earlier, this chapter will emphasize considerations in T2DM.

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Disclosures

WDL (all fees paid to facility): Speaker bureau: Amgen, Eli Lilly, Novartis. Research grants: Amgen, Genzyme. SH: None.

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Authors and Affiliations

  1. Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg, MB, Canada, R2H 2A6

    William D. Leslie M.D.

  2. Division of Endocrinology, Department of Medicine, Tygerberg (deceased) Academic Hospital, Stellenbosch University, Cape Town, Western Province, South Africa

    Stephen Hough M.D.

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  1. William D. Leslie M.D.
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Correspondence to William D. Leslie M.D. .

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Editors and Affiliations

  1. Departments of Orthopedic Surgery, Physiology and Pharmacology, Center for Diabetes and Endocrine Research; University of Toledo, Toledo, Ohio, USA

    Beata Lecka-Czernik

  2. Departments of Pediatrics, Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA

    John L. Fowlkes

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Leslie, W.D., Hough, S. (2016). Fracture Risk Assessment in Diabetes. In: Lecka-Czernik, B., Fowlkes, J. (eds) Diabetic Bone Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-16402-1_3

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