DIABETES MELLITUS AND OSTEOPOROSIS: A MODERN VIEW OF THE PROBLEM AND TREATMENT OPTIONS
Saidjonova Feruza Latifjonovna
Assistant Department of Pathological Anatomy Andijan State Medical Institute
##semicolon## Diabetes mellitus, osteoporosis, bone metabolism, insulin signaling, treatment options.
सार
Diabetes mellitus (DM) and osteoporosis are two prevalent metabolic disorders that often coexist, presenting a complex interplay with significant clinical implications. This paper aims to provide a comprehensive overview of the relationship between DM and osteoporosis, exploring underlying mechanisms, shared risk factors, and potential treatment strategies. A thorough literature review was conducted, examining recent research findings and clinical studies on this topic. The paper discusses the impact of DM on bone metabolism, the role of insulin signaling pathways, and the influence of chronic hyperglycemia on bone tissue. Furthermore, it explores the bidirectional relationship between DM and osteoporosis, highlighting how osteoporosis may exacerbate diabetic complications and vice versa. Various treatment options, including lifestyle modifications, pharmacotherapy, and emerging therapies targeting both DM and osteoporosis, are also discussed. Overall, a multidisciplinary approach integrating diabetes management and osteoporosis prevention is crucial for optimizing patient outcomes and reducing the burden of these interconnected conditions.
##submission.citations##
International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels, Belgium: International Diabetes Federation; 2019.
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285(6):785-795.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Suppl 1):S81-S90.
Thrailkill KM, Lumpkin CK Jr, Bunn RC, Kemp SF, Fowlkes JL. Is insulin an anabolic agent in bone? Dissecting the diabetic bone for clues. Am J Physiol Endocrinol Metab. 2005;289(5):E735-E745.
Saito M, Marumo K. Collagen cross-links as a determinant of bone quality: a possible explanation for bone fragility in aging, osteoporosis, and diabetes mellitus. Osteoporos Int. 2010;21(2):195-214.
Starup-Linde J. Diabetes, biochemical markers of bone turnover, diabetes control, and bone. Front Endocrinol (Lausanne). 2013;4:21.
Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes—a meta-analysis. Osteoporos Int. 2007;18(4):427-444.
Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017;13(4):208-219.
Schwartz AV, Vittinghoff E, Bauer DC, et al. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA. 2011;305(21):2184-2192.
Janghorbani M, Van Dam RM, Willett WC, Hu FB. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007;166(5):495-505.
Bonds DE, Larson JC, Schwartz AV, et al. Risk of fracture in women with type 2 diabetes: the Women's Health Initiative Observational Study. J Clin Endocrinol Metab. 2006;91(9):3404-3410.
Vestergaard P, Rejnmark L, Mosekilde L. Diabetes and its complications and their relationship with risk of fractures in type 1 and 2 diabetes. Calcif Tissue Int. 2009;84(1):45-55.
de Liefde II, van der Klift M, de Laet CE, van Daele PL, Hofman A, Pols HA. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos Int. 2005;16(12):1713-1720.
Kanazawa I, Yamaguchi T, Yamamoto M, et al. Serum osteocalcin level is positively associated with insulin sensitivity and secretion in patients with type 2 diabetes. Bone. 2011;48(4):720-725.
Napoli N, Strotmeyer ES, Ensrud KE, et al. Fracture risk in diabetic elderly men: the MrOS Study. Diabetologia. 2014;57(10):2057-2065.
Dede AD, Tournis S, Dontas I, Trovas G. Type 2 diabetes mellitus and fracture risk. Metabolism. 2014;63(12):1480-1490.
Vestergaard P, Rejnmark L, Mosekilde L. Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia. 2005;48(7):1292-1299.
Сахарный диабет: Клиника, диагностика, лечение" (Diabetes Mellitus: Clinical Presentation, Diagnosis, Treatment), В.И. Дедов, Э.В. Шестакова.
"Остеопороз: патогенез, диагностика, лечение" (Osteoporosis: Pathogenesis, Diagnosis, Treatment), М.А. Кобылянский and С.В. Лишенко.