scholarly journals Effect of Antidiabetic Treatment on Bone

2019 ◽  
pp. S107-S120 ◽  
Author(s):  
J. JACKULIAK ◽  
M. KUŽMA ◽  
J. PAYER
Keyword(s):  
Diabetes Mellitus ◽  
Bone Fractures ◽  
Negative Impact ◽  
Osteoporotic Fractures ◽  
Antidiabetic Drugs ◽  
Mineral Density ◽  
Skeletal Health ◽  
Antidiabetic Treatment ◽  
Increased Risk ◽  
Patients With Diabetes

Patients with diabetes mellitus are at an increased risk of bone fractures. Several groups of effective antidiabetic drugs are available, which are very often given in combination. The effects of these medications on bone metabolism and fracture risk must not be neglected. Commonly used antidiabetic drugs might have a positive, neutral or negative impact on skeletal health. Increased risk of fracture has been identified with use of thiazolidinediones, most definitively in women. Also treatment with sulfonylureas can have adverse effects on bone. One consequence of these findings has been greater attention to fracture outcomes in trails of new diabetes medication (incretins and SGLT-2 inhibitors). The effect of insulin on bone is discussed and the risk of fractures in patients using insulin seems to be unrelated to insulin as itself. The aim of the review is to summarize effects of antidiabetic treatment on bone – bone mineral density, fractures and bone turnover markers. The authors also try to recommend a strategy how to treat patients with diabetes mellitus regarding the risk of osteoporotic fractures. In this review the problem of how to treat osteoporosis in patient with diabetes is also discussed.

scholarly journals Osteoporosis in Men with Diabetes Mellitus

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Claire Issa ◽  
Mira S. Zantout ◽  
Sami T. Azar
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Vitamin D ◽  
Risk Factor ◽  
Bone Fractures ◽  
Mineral Density ◽  
Vitamin D Intake ◽  
Osteoporosis In Men ◽  
Patients With Diabetes ◽  
Male Patients

Osteoporosis is more common in women than in men. The prevalence in men is not defined yet; however it is becoming much more recognized as its prevalence and impact have become explicable. It is estimated that around 1% of bone mineral density is lost in men every year. Studies show that secondary osteoporosis is the major cause thus, making it important to define the disorders associated with male osteoporosis. Diabetes is a risk factor for bone fractures. In male patients with diabetes measures should be undertaken such as encouraging exercise, assuring adequate calcium and vitamin D intake, and treating diabetic complications.

scholarly journals Pathogenetic aspects of bone metabolism in diabetes mellitus.

2018 ◽  
Vol 96 (8) ◽  
pp. 707-712
Author(s):  
S. S. Safarova
Keyword(s):  
Diabetes Mellitus ◽  
Bone Tissue ◽  
Molecular Mechanisms ◽  
Bone Structure ◽  
Advanced Glycation Endproducts ◽  
Fatty Infiltration ◽  
Osteoporotic Fractures ◽  
Inflammatory Factors ◽  
Mineral Density ◽  
Increased Risk

Metabolic disorders caused by diabetes affect bone remodeling, alter the structure and reduce the strength of bone tissue, leading to the development of diabetic osteopathy. However, between diabetes mellitus (DM) type 1 and 2 there are noticeable differences in the effect on the bone structure, which is obviously due to the different cellular and molecular mechanisms of these processes. The density of bone tissue with DM typel decreases, which leads to an increase in the risk of fractures by 7 times. With DM type 2, bone mineral density is moderately elevated, which is expected to lead to a decrease in the incidence of osteoporotic fractures, but in fact, this index is approximately doubled. Pathophysiological mechanisms underlying osteoporotic changes in diabetes mellitus are complex and included hyperglycemia, oxidative stress and accumulation of advanced glycation endproducts that alter the properties of collagen, increase fatty infiltration of the bone marrow, release inflammatory factors and adipokines from visceral adipose tissue and potentially change the function osteoblasts. Additional factors are, some antidiabetic drugs that directly affect the metabolism of bones and minerals (such as thiazolidinediones), as well as an increased tendency to fall due to micro- and macroangiopathies, all contribute to an increased risk of low-fracture fractures in patients with diabetes mellitus.

STUDY OF LIFE QUALITY AND TREATMENT SATISFACTION OF ROMANIAN DIABETIC PATIENTS

2019 ◽  
Vol 7 ◽  
pp. 771-777
Author(s):  
Andrei Cătălin Muntean ◽  
Claudiu Morgovan ◽  
Smaranda Cosma ◽  
Smaranda Cosma ◽  
Anca Butucă ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Current System ◽  
Life Quality ◽  
Open Circuit ◽  
Antidiabetic Drugs ◽  
Patient Treatment ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Antidiabetic Treatment ◽  
Patients With Diabetes

In Romania, antidiabetic medication is free, based on a program of the Ministry of Public Health: “Treatment of patients with diabetes mellitus”. Since October 1, 2006, antidiabetic drugs have been delivered through open circuit pharmacies in contractual relationship with the National Health Insurance House, after four years of centralized delivery through hospital pharmacies. Objectives: This study aims to describe the influences of the diabetes treatment regarding patients’ quality of life and their satisfaction. Methods: A cross-sectional descriptive study was performed in pharmacies. The study includes 477 patients with diabetes mellitus from Cluj County, Romania. The interviewing method was used on a questionnaire base. The participants included in the study admitted to participate in May-June, 2016. The questionnaire was systematically developed following comprehensive literature review and structured according to 3 main fields: 1) patient demographics; 2) diabetes patient treatment and 3) glycaemia control and patient satisfaction. Results: The research performed in two months showed that 78% of the respondents used oral antidiabetics for treatment, more than 19% of the inquired patients reached normal glycaemia values following antidiabetic treatment, and about 82% of patients were satisfied with the current system of acquisition of antidiabetic drugs. Conclusions: The treatment with antidiabetic drugs maintains a relatively good health status. Also, the life expectancy of diabetic patients has increased over the past period.

scholarly journals RISK FACTORS OF LOW-ENERGY FRACTURES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2018 ◽  
Vol 25 (4) ◽  
pp. 115-123
Author(s):  
G. M. NURULLINA ◽  
G. I. AKHMADULLINA ◽  
O. V. KRASNOPEROVA ◽  
M. M. ALEKSEEVA ◽  
O. V. ALEKSANDROVA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Large Scale ◽  
Osteoporotic Fractures ◽  
Diabetic Patients ◽  
Social Significance ◽  
Mineral Density ◽  
Increased Risk ◽  
Long Time ◽  
Risk Of Falls

Osteoporosis is a metabolic disease of the bone tissue, which is characterized by a violation of the qualitative (microarchitecture  change) and quantitative characteristics (decreased bone mass) of  the skeleton, and, as a result, lowenergy fractures. The medical and  social significance of osteoporosis is due to its consequences:  fractures of the femoral neck, vertebral bodies, radius and other  large bones of the skeleton, which significantly reduces the quality of patients’ lives and entails significant financial costs for treatment and rehabilitation.  Prevalence of diabetes mellitus (DM) significantly  increases in all countries of the world, including the Russian  Federation. Diabetes and osteoporosis were considered to be  individual diseases for a long time. In many prospective large-scale studies it was proved that patients with T2DM have a greater risk of  falls and fractures in contrast with the overall population. Despite the increased risk of fractures in diabetic patients, there is still no risk  stratification in these patients. The link between the classic risk  factors of osteoporotic fractures (such as chronic intake of  glucocorticoids, use of alcohol, tobacco, etc.) and the occurrence of  fractures is similar in patients with both T2DM and without it.  However, it is necessary to take into account other characteristics of  diabetes. The specific risk factors of fractures in T2DM patients are  duration of the diabetes for more than 10 years, diabetes decompensation, the severity of diabetes, obesity, the frequency of  falls, hypoglycemia, insulin, thiazolidinedione, exenatide, sulfonylureas, canagliflozin therapy, and, most likely, the reduction  of 25 (OH) vitamin D, functional hypoparathyroidism, the increase of sclerostin, pentosidine, decreased bone mineral density (BMD) of the hip.

scholarly journals Diabetic Skeletal Health and Potential Benefits of Exercise

2019 ◽  
Vol 8 (3) ◽  
pp. 108-114
Author(s):  
Elizabeth O'Neill
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Bone Tissue ◽  
Bone Health ◽  
Cellular Activity ◽  
Mineral Density ◽  
Skeletal Health ◽  
Increased Risk ◽  
Potential Benefits ◽  
Potential Methods

ABSTRACT Bone tissue undergoes continual remodeling through resorption and formation. The balance between these 2 activities is critical to optimizing bone mineral density (BMD) and the biomechanical integrity of the tissue, thereby reducing fractures. There is increasing evidence that diabetes negatively alters the cellular activity of bone tissue and reduces bone quality resulting in an increased risk of fractures. The mechanisms by which diabetes impacts bone are not completely understood; however, insulin, hyperglycemia, and glycation appear to influence skeletal regulation. This review will explore the influence of diabetes mellitus on bone as well as examine the potential methods by which exercise can serve as a nonpharmacological method to optimize bone health in persons with diabetes.

scholarly journals Features of bone metabolism in diabetes mellitus

2018 ◽  
Vol 20 (3) ◽  
pp. 82-89 ◽  
Author(s):  
Guzel M. Nurullina ◽  
Guzyal I. Akhmadullina
Keyword(s):  
Diabetes Mellitus ◽  
Bone Formation ◽  
Bone Metabolism ◽  
Bone Remodeling ◽  
Osteoporotic Fractures ◽  
Bone Fragility ◽  
Obesity And Diabetes ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Low Bone Turnover

Patients with diabetes mellitus (DM) have an increased risk of osteoporotic fractures, which is associated with a bone fragility. Accumulation of advanced glycation end products, hyperhomocysteinemia causes increased apoptosis of osteocytes, decreased bone formation and bone remodeling in DM. Adiponectin stimulates osteocalcin expression and osteoblast differentiation through the activation of AMPK. AMPK-activation stimulates differentiation and mineralization of osteoblasts. Hypoadiponectinemia, which is often observed in obesity and diabetes, can causes bone fragility. Diabetes mellitus is a state of low bone turnover, which is confirmed by decreased markers of bone formation (osteocalcin, P1NP), decreased markers of bone resorption (CTX, TRAP), increased regulatory markers of bone remodeling (OPG, sclerostin). Thus, the study of the pathophysiology of bone metabolism, the level of bone metabolism markers in patients with diabetes mellitus gives broad prospects in understanding the mechanisms of osteoporosis as complication of diabetes mellitus, the selection of targeted therapy and the improvement of early diagnosis of the disease.

scholarly journals Heart failure and diabetes mellitus: insight into comorbidity

2019 ◽  
Vol 22 (1) ◽  
pp. 79-87
Author(s):  
Nina A. Petunina ◽  
Ivan V. Trukhin ◽  
Liubov V. Trukhina ◽  
Zhanna M. Sizova ◽  
Valeria L. Zakharova
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Antidiabetic Drugs ◽  
Antidiabetic Treatment ◽  
Increased Risk ◽  
Bidirectional Relationship ◽  
Structural Abnormalities ◽  
Patients At Risk ◽  
Artery Disease ◽  
Insight Into

Diabetes mellitus (DM) and heart failure (HF) are frequent comorbidities with a bidirectional relationship. Patients with HF have increased risk of developing DM, and those with DM are at greater risk of developing HF. HF does not fit clearly into the microangiopathy and macroangiopathy groups. It is known that coronary artery disease and arterial hypertension are the major causes of HF; however, it has been shown that DM can trigger functional and structural abnormalities in the myocardium via diabetic cardiomyopathy, a condition with either restrictive or dilated phenotype. While HF treatment is equally effective and safe in patients with and without DM, this statement is not applicable for antidiabetic treatment. Several antidiabetic drugs, such as rosiglitazone, pioglitazone and saxagliptin increase the risk of hospitalisation for HF, therefore these antidiabetic drugs are contraindicated in patients with DM and HF or patients at risk of developing HF. Despite a large number of clinical evidence, uncertainty about the safety of antidiabetic drugs in patients with HF always exists. In this review, the issues of DM treatment in patients with HF are addressed in detail.

scholarly journals OsteoporosAtlas: a human osteoporosis-related gene database

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6778 ◽  
Author(s):  
Xun Wang ◽  
Lihong Diao ◽  
Dezhi Sun ◽  
Dan Wang ◽  
Jiarun Zhu ◽  
...  
Keyword(s):  
Complex Disease ◽  
Treatment Strategies ◽  
Osteoporotic Fractures ◽  
Relevant Information ◽  
Extensive Literature ◽  
Mineral Density ◽  
Common Complex Disease ◽  
Increased Risk ◽  
Prevention And Treatment ◽  
Pathway Analyses

Background Osteoporosis is a common, complex disease of bone with a strong heritable component, characterized by low bone mineral density, microarchitectural deterioration of bone tissue and an increased risk of fracture. Due to limited drug selection for osteoporosis and increasing morbidity, mortality of osteoporotic fractures, osteoporosis has become a major health burden in aging societies. Current researches for identifying specific loci or genes involved in osteoporosis contribute to a greater understanding of the pathogenesis of osteoporosis and the development of better diagnosis, prevention and treatment strategies. However, little is known about how most causal genes work and interact to influence osteoporosis. Therefore, it is greatly significant to collect and analyze the studies involved in osteoporosis-related genes. Unfortunately, the information about all these osteoporosis-related genes is scattered in a large amount of extensive literature. Currently, there is no specialized database for easily accessing relevant information about osteoporosis-related genes and miRNAs. Methods We extracted data from literature abstracts in PubMed by text-mining and manual curation. Moreover, a local MySQL database containing all the data was developed with PHP on a Windows server. Results OsteoporosAtlas (http://biokb.ncpsb.org/osteoporosis/), the first specialized database for easily accessing relevant information such as osteoporosis-related genes and miRNAs, was constructed and served for researchers. OsteoporosAtlas enables users to retrieve, browse and download osteoporosis-related genes and miRNAs. Gene ontology and pathway analyses were integrated into OsteoporosAtlas. It currently includes 617 human encoding genes, 131 human non-coding miRNAs, and 128 functional roles. We think that OsteoporosAtlas will be an important bioinformatics resource to facilitate a better understanding of the pathogenesis of osteoporosis and developing better diagnosis, prevention and treatment strategies.

scholarly journals Prevalence of osteoporosis and osteoporotic fractures in postmenopausal women with type 2 diabetes mellitus

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Lamia Oulkadi ◽  
Bouchra Amine ◽  
Imane El binoune ◽  
Samira Rostom ◽  
Rachid Bahiri
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Postmenopausal Women ◽  
Mineral Density ◽  
Control Subjects ◽  
Increased Risk ◽  
Significant Difference ◽  
Prevalence Of Osteoporosis

Type 2 diabetes mellitus (T2DM) and osteoporosis are chronic diseases with increasing prevalence. The aim of this study was to determine the prevalence of osteoporosis and osteoporotic fracture in women with T2DM and to identify predictive factors of fracture occurrence. The prevalence of osteoporosis and fractures in postmenopausal women with T2DM was 23.1% and 16.9%, respectively. 46.2% of T2DM patients had normal bone mineral density (BMD) (P<0.01) and 58.5% of control subjects had osteopenia (P<0.01). Incidence of fracture in T2DM patients with osteopenia was significantly increased versus control subjects when stratified according the BMD (P=0.009). By stratifying T2DM patients according to fractures, factors that were significantly associated with occurrence included T2DM duration (P=0.038), use of insulin (P=0.017), and lower BMD (P=0.048). Our study suggests that there was a higher prevalence of fracture in T2DM patients compared to control subjects and a significant difference in BMD was found between the groups. We also showed that insulin use, low BMD, and long duration of T2DM are factors associated with an increased risk of bone fracture.

scholarly journals Association Between moleculars and Osteoporotic Fracture Risk:A systematical review

2020 ◽  
Author(s):  
Jie-Yu Liu ◽  
Jia-Xiang Wang ◽  
Li Xu ◽  
Shu-Feng Lei ◽  
Fei-Yan Deng
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Elderly Population ◽  
Early Recognition ◽  
Osteoporotic Fractures ◽  
Middle Aged ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Increased Risk

AbstractOsteoporosis is a systemic chronic skeletal disease, which is characterized by low bone mineral density (BMD) and increased risk to osteoporotic fractures (OFs). OFs are associated with high mortality and morbidity, and seriously affect the life quality of patients. Osteoporosis is prevalent in the middle-aged and elderly population, especially the postmenopausal women. With population aging, osteoporosis becomes a world-wide serious public health problem. Early recognition of the high-risk population followed by timely and efficient intervention and/or treatment is important for preventing OFs. In light of the high heritability and complex pathogenesis of OP, comprehensive consideration of significant biological/biochemical factors is necessary for accurate risk evaluation. For this purpose, we reviewed recent research progress on moleculars which are diagnostic and/or predictive of OFs risk. Future integrative analyses and systematic evaluation of these moleculars may facilitate developing novel methodologies and/or test strategies, i.e., biochips, for early recognition of osteoporosis, hence to contribute to preventing OFs in the world.Graphical AbstractOsteoporosis, which is characterized by low bone mineral density (BMD) and increased risk to osteoporotic fractures (OFs), is prevalent in the middle-aged and elderly population, especially in the postmenopausal women. We focused on several types of important molecules, including proteins/peptides, RNAs, lipids, to gain comprehensive understanding and to generate novel perspectives in predicting and diagnosing OFs.

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