The Effect of Diabetes on Bone Structure and Fracture Risk: Insights from a Recent Review
A recent review reveals how diabetes affects bone microarchitecture and increases fracture risk, emphasizing the need for advanced diagnostic tools like TBS for better fracture prediction in diabetic patients.
A comprehensive review published in Osteoporosis International highlights the significant impact of diabetes mellitus on bone health and fracture susceptibility. The research, authored by experts including Professor Serge Ferrari, examines how diabetes alters bone microarchitecture, leading to increased fragility despite normal or even elevated bone mineral density (BMD) in many cases.
The review, titled "Bone microstructure and TBS in diabetes: what have we learned?" discusses the paradox observed in type 2 diabetes (T2DM): individuals often have higher BMD yet face a notably higher risk of fractures. Conversely, type 1 diabetes (T1DM) is typically associated with decreased BMD and compromised bone microarchitecture, especially in cortical and trabecular regions, heightening fracture risk.
Advanced imaging techniques reveal that T2DM patients frequently exhibit increased trabecular bone mass, but this is counterbalanced by increased cortical porosity and alterations in bone material properties. These structural changes, particularly in cortical bone, involve greater porosity and may be influenced by the accumulation of advanced glycation end-products (AGEs), which impair bone quality.
A critical tool discussed is the Trabecular Bone Score (TBS), an indirect measure derived from lumbar spine DXA scans, which assesses bone microarchitecture. The review emphasizes that TBS values tend to be lower in diabetic individuals, correlating with increased fracture risk. However, the presence of excess abdominal fat common in T2DM can artificially lower TBS readings due to current measurement limitations, necessitating algorithm updates that account for tissue thickness.
The authors advocate for integrating improved TBS algorithms and more longitudinal studies to better understand diabetic bone disease. They stress that routine clinical assessment should include such advanced diagnostic tools to more accurately predict fracture risk. Recognizing the microstructural changes parallels the importance of early intervention and tailored treatment strategies for diabetic patients.
In conclusion, this review signals a paradigm shift in understanding diabetic osteoporosis. It underscores the importance of comprehensive skeletal assessment beyond BMD, utilizing tools like TBS to enhance fracture risk prediction in people with diabetes and improve clinical outcomes.
Source: https://medicalxpress.com/news/2025-06-impact-diabetes-bone-health-fracture.html
Stay Updated with Mia's Feed
Get the latest health & wellness insights delivered straight to your inbox.
Related Articles
Advancements in Newborn Genomic Screening for Early Disease Detection
Discover how integrating genomic sequencing into newborn blood screening can lead to early detection of treatable childhood conditions, saving lives and improving outcomes. A recent study highlights the feasibility, acceptance, and life-saving potential of this innovative approach.
High Rate of Defective Cancer Medications Detected in Sub-Saharan Africa
A recent study reveals that one in six cancer medications in sub-Saharan Africa are defective, risking patient safety due to substandard active ingredient levels. This highlights the need for improved regulation and innovative testing solutions.
Promising Results of Zidesamtinib in Treating ROS1-Positive NSCLC Patients Post-TKI Therapy
Zidesamtinib shows promising durable responses in ROS1-positive NSCLC patients, including those with brain metastases and prior TKI treatment, demonstrating potential as a targeted therapy option.
Surge in Whooping Cough Cases in Washington State Amid Declining Vaccination Rates
Washington State is experiencing a sharp rise in whooping cough cases, driven by declining vaccination rates, with severe health risks especially for infants. Learn more about the outbreak and the importance of immunization.