TY  - JOUR
AU  - Al-Mashhadi, Zheer
AU  - Viggers, Rikke
AU  - Fuglsang-Nielsen, Rasmus
AU  - Langdahl, Bente
AU  - Vestergaard, Peter
AU  - Gregersen, Søren
AU  - Starup-Linde, Jakob
PY  - 2020
DA  - 2020/06/18
TI  - Bone Health in the Elderly with Type 2 Diabetes Mellitus–A Systematic Review
JO  - OBM Geriatrics
SP  - 123
VL  - 04
IS  - 02
AB  - Type 2 diabetes mellitus (T2DM) and osteoporosis are two major public health concerns worldwide, contributing to morbidity and mortality in the elderly. Aging is one of the most significant risk factors for low bone mass, bone fragility, and fractures. Among the several comorbidities that affect the elderly with diabetes, increased fracture risk is a relatively recently discovered complication. Generally, individuals with T2DM exhibit higher bone mineral density, which complicates the assessment of fracture risk. Despite the growing evidence for an association between T2DM and increased fracture risk, especially among the elderly, the underlying mechanism has not yet been fully uncovered, and proper evaluation of bone health in individuals with T2DM remains a challenge. The present review includes 125 articles investigating the effects of T2DM on bone health in the elderly. A systematic literature search was performed in PubMed, Embase, and CINAHL for articles containing terms corresponding to ‘elderly’ and ‘type 2 diabetes mellitus’ along with ‘bone fracture’, ‘osteoporosis’, or ‘bone turnover’. Articles investigating the effects of T2DM and disease severity, duration, or complications on bone parameters – i.e. fracture risk, structure, and turnover – were selected for inclusion in the present review. Overall, the evidence indicated reduced bone turnover in individuals with T2DM, accompanied by an increased bone mineral density (BMD) and an inefficient distribution of bone mass with accumulated trabecular bone and diminished cortical bone. These structural alterations in bone tissues result in bone fragility and overall increased fracture risk in elderly individuals with T2DM. However, measurement of BMD does not adequately predict the increased fracture risk in T2DM. Therefore, identification and application of more precise predictors of fracture risk in individuals with T2DM are required. Furthermore, a better understanding of the pathophysiological mechanisms involved may assist in developing effective treatments of bone disease in individuals with diabetes. The present review introduces current candidates for improved measures of bone quality and fracture risk along with the current knowledge on the pathophysiology of diabetic bones.
SN  - 2638-1311
UR  - https://doi.org/10.21926/obm.geriatr.2002123
DO  - 10.21926/obm.geriatr.2002123
ID  - Al-Mashhadi2020
ER  -