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Treatment of bone fragility in patients with diabetes: antiresorptive versus anabolic?

Meghna Shah1, Anusha Veeravanallur Appuswamy1, Sudhaker D Rao2

  • 1Metabolic Bone Disease Center, State University of New York Upstate Medical University, Syracuse, New York.

Current Opinion in Endocrinology, Diabetes, and Obesity
|May 19, 2021
PubMed
Abstract

Insights

Diabetic bone fragility lacks proven treatments. While some therapies show promise, more research is needed to confirm their effectiveness and guide optimal treatment for diabetic patients.

Area of Science:

  • Endocrinology
  • Metabolic Bone Disease
  • Diabetes Mellitus

Background:

  • Diabetic bone fragility pathogenesis is unclear.
  • Antifracture efficacy of current therapies is unproven in diabetic patients.
  • Limited evidence exists from observational studies and post hoc analyses.

Purpose of the Study:

  • Collate evidence on treating diabetic bone fragility.
  • Provide rationale for optimal therapeutic options.
  • Address the need for specific treatment guidelines.

Main Methods:

  • Review of existing literature on bone fragility in diabetes.
  • Analysis of antiresorptive and anabolic therapies.
  • Comparison of treatment efficacy in diabetic vs. non-diabetic populations.

Main Results:

  • Antiresorptive and anabolic therapies show similar effects on bone density and fracture risk in diabetic and non-diabetic individuals.
  • Evidence for efficacy in diabetes is limited.
  • Anabolic therapies may be beneficial in diabetes due to low bone formation state.

Conclusions:

  • No specific guidelines exist for treating diabetic bone fragility.
  • Prospective studies are needed to evaluate therapies' effects on bone quality and fracture outcomes.
  • Further research is crucial for effective management of diabetic bone disease.

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