Public Release: 

IOF urges early evaluation of fracture risk in diabetics

New review summarizes current knowledge on the mechanisms, evaluation and management of bone fragility in type 1 diabetes; calls for regular evaluation of fracture risk as well as more research into the role of osteoporosis drugs in diabetic patients

International Osteoporosis Foundation

This news release is available in Spanish.

Nyon, Switzerland - December 2, 2015

Despite an up to six-fold increased risk of broken bones in patients with type 1 diabetes mellitus (T1DM), the relationship between diabetes and osteoporosis has, until recently, suffered from a general lack of attention and research. As a result, health professionals who treat diabetic patients often do not recognize that fragility fractures are a major complication of the disease.

In order to promote understanding of the latest advances and to encourage early evaluation of fracture risk, the International Osteoporosis Foundation (IOF) Bone and Diabetes Scientific Working Group has now published a succinct review which provides endocrinologists with valuable information in regard to fracture risk in T1DM patients.

Prof. Serge Ferrari, Chair of the IOF Bone and Diabetes Working Group and Professor at the Geneva University Hospital, Switzerland stated, "Although more studies are needed, researchers have recently made encouraging progress in elucidating the complex relationship between bone and diabetes. The findings underline the need for early evaluation and fracture prevention strategies."

Published in the European Journal of Endocrinology, the review summarizes the latest knowledge on the:

  • Epidemiology of fracture risk in diabetic patients
  • Quantitative and structural bases of bone fragility
  • Bone turnover and the continued process of bone loss and replacement
  • Cellular and molecular mechanisms of diabetic bone disease
  • Evaluation and management of bone fragility in T1DM

The higher fracture risk in T1DM patients is not only due to decreased bone mineral density, but also to alterations in bone quality. Recent clinical studies point to impaired osteoblastic bone formation, with or without increased bone resorption. Insulin deficiency also appears to be a major pathophysiological mechanism involved, along with other metabolic alterations that may all play a role in altering bone turnover and bone quality.

As the onset of T1DM often occurs during childhood, the assessment and management of bone health in the young is of special concern. General measures to prevent osteoporosis in children with early onset of diabetes include a balanced diet with adequate calcium and vitamin D intake and, in particular, sufficient physical activity. Increasing weight-bearing exercise in children with diabetes as well as good glycaemic control appears to provide some improvement of bone parameters.

Prof. Ferrari added, "As fragility fractures are a major complication of diabetes, fracture risk should be properly evaluated in patients with this disorder. Research is urgently needed on the benefits and risks of osteoporosis therapy as so far none of the anti-osteoporotic agents have been tested for their anti-fracture efficacy in T1DM subjects. This is all the more reason for health professionals to focus on early evaluation and other fracture prevention strategies in their patients."

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Reference:

Mechanisms and Evaluation of Bone Fragility in Type 1 Diabetes Mellitus
FS Hough, DD Pierroz, C Cooper, SL Ferrari, and IOF CSA Bone and Diabetes Working Group. Published online before print. doi: 10.1530/EJE-15-0820
Eur J Endocrinol November 4, 2015 EJE-15-0820
http://www.eje-online.org/content/early/2015/11/04/EJE-15-0820.long

IOF Regionals 3rd Middle East & Africa Osteoporosis Meeting

The review will be presented at the 'Bone & Diabetes Workshop' to be held in conjunction with the International Osteoporosis Foundation (IOF) regional meeting in Abu Dhabi, from December 5-7, 2015. The IOF Regionals will be one of the largest medical and research events dedicated to osteoporosis and related diseases in the region. http://www.iofbonehealth.org/abudhabi-2015

About IOF

The International Osteoporosis Foundation (IOF) is a not-for-profit, nongovernmental organization dedicated to the worldwide fight against osteoporosis and related musculoskeletal diseases. IOF's members - scientific researchers, patient, medical and research societies and industry representatives from around the world - share a common vision of a world without osteoporotic fractures. IOF, with headquarters in Switzerland, includes 232 member societies in 98 countries, regions and territories. Among its numerous programmes and activities, IOF mobilizes the global osteoporosis movement on World Osteoporosis Day, marked on October 20 every year. http://www.iofbonehealth.org; http://www.facebook.com/iofbonehealth; http://twitter.com/iofbonehealth; http://www.worldosteoporosisday.org

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