Mária Rašiová, Miriam Kozárová
The association of osteoporosis and Type 1 diabetes mellitus (T1DM) is beyond doubt; however, there remains inconsistency in opinion concerning osteoporosis in Type 2 diabetes mellitus (T2DM). Meta-analyses of observational studies in T2DM have documented, in both sexes, significantly higher bone density (BMD) of the femur and of the spine. Despite the increased BMD, fracture risk of the proximal end of the femur, spine, ankle and foot in T2DM is increased, thus detection of BMD underestimates fracture risk. Mechanism of increased bone fragility in T2DM is not fully explained; the proportion of chronic hyperglycaemia with formation of advanced glycation products, insulin resistance and also adipokines is assumed. Numerous complications of diabetes increase risk of falls. Although bones are stronger, they are more fragile. Bone metabolism might be affected by pharmacotherapy of diabetes and associated diseases.