关键词: Fractures Insulin resistance Osteoporosis Type 1 diabetes Type 2 diabetes

Mesh : Bone Density Bone Density Conservation Agents / therapeutic use Bone Remodeling Consensus Diabetes Mellitus, Type 1 / complications diagnosis drug therapy Diabetes Mellitus, Type 2 / complications diagnosis drug therapy Early Diagnosis Glycemic Control / adverse effects Humans Hypoglycemic Agents / adverse effects Insulin Resistance Osteoporosis / diagnosis etiology prevention & control Osteoporotic Fractures / diagnosis etiology prevention & control Risk Assessment Risk Factors Treatment Outcome

来  源:   DOI:10.1016/j.numecd.2021.01.019   PDF(Sci-hub)

Abstract:
Bone fragility is one of the possible complications of diabetes, either type 1 (T1D) or type 2 (T2D). Bone fragility can affect patients of different age and with different disease severity depending on type of diabetes, disease duration and the presence of other complications. Fracture risk assessment should be started at different stages in the natural history of the disease depending on the type of diabetes and other risk factors. The risk of fracture in T1D is higher than in T2D, imposing a much earlier screening and therapeutic intervention that should also take into account a patient\'s life expectancy, diabetes complications etc. The therapeutic armamentarium for T2D has been enriched with drugs that may influence bone metabolism, and clinicians should be aware of these effects. Considering the complexity of diabetes and osteoporosis and the range of variables that influence treatment choices in a given individual, the Working Group on bone fragility in patients with diabetes mellitus has identified and issued recommendations based on the variables that should guide screening of bone fragility and management of diabetes and bone fragility: (A)ge, (B)MD, (C)omplications, (D)uration of disease, & (F)ractures (ABCD&F). Consideration of these parameters may help clinicians identify the best time for screening, the appropriate glycaemic target and anti-osteoporosis drug for patients with diabetes at risk of or with bone fragility.
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