Diagnosis and treatment of osteoporosis in elderly patients with type 2 diabetes
https://doi.org/10.37586/2686-8636-2-2020-159-164
Abstract
Osteoporosis, falls and low-energy fractures have a high prevalence in elderly, which is increasing in the presence of diabetes mellitus type 2 (T2DM). Patients with T2DM have a low rate of bone metabolism, a pronounced change in bone microarchitecture. The use of trabecular bone score in evaluating of densitometry and the FRAX scale improves the sensitivity of the methods in patients with diabetes. Integrated approach is required in elderly patient with type 2 diabetes and includes assessment of geriatric status, diabetes status, correction of multiple complications of diabetes, carbohydrate metabolism, vitamin D deficiency, selection of the most effective hypoglycemic and anti-osteoporetic therapy and development of preventive and treatment methods aimed to reduce falls risk and fractures rate.
About the Authors
N. V. Brailova
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical Centre
Russian Federation
Russian Federation
MD, PhD, junior research fellow, laboratory of age-related endocrine and metabolic disorders
eLibrary SPIN: 2900-8384
Moscow
E. N. Dudinskaya
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical Centre
Russian Federation
Russian Federation
MD, PhD, Head of age-related endocrine and metabolic disorders laboratory
+7(903) 191-46-90
Moscow
L. V. Machekhina
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical Centre
Russian Federation
Russian Federation
MD, PhD, research fellow, laboratory of age-related endocrine and metabolic disorders
eLibrary SPIN: 6453-5835
Moscow
O. N. Tkacheva
Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Russian Gerontology Research and Clinical Centre
Russian Federation
Russian Federation
MD, PhD, professor, Director
+7(499) 187-64-67
Moscow
References
1. Cooper C., Campion G., Melton L.J. 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992; 2(6): 285–289.
2. Grados F., Marcelli C., Dargent-Molina P., et al. Prevalence of vertebral fractures in French women older than 75 years from the EPIDOS study. Bone. 2004; 34(2): 362–367.
3. Leslie W.D., Rubin M.R., Schwartz A.V., Kanis J.A. Type 2 diabetes and bone. J Bone Miner Res. 2012; 27(11): 2231–2237. DOI: 10.1002/jbmr.1759.
4. Yalochkina T.O., Belaya J.E., Rozhinskaya L.Y., et al. Bone fractures in patients with type 2 diabetes mellitus: prevalence and risk factors. Diabetes mellitus. 2016; 19(5): 359–365. (In Russ.). DOI: 10.14341/dm7796.
5. Schwartz A.V., Sellmeyer D.E., Ensrud K.E., et al. Older Women with Diabetes Have an Increased Risk of Fracture: A Prospective Study. J Clin Endocr Metab. 2001; 86(1): 32–38. DOI: 10.1210/jcem.86.1.7139.
6. Bonds D.E., Larson J.C., Schwartz A.V., et al. Risk of Fracture in Women with Type 2 Diabetes: the Women’s Health Initiative Observational Study. J Clin Endocr Metab. 2006; 91(9): 3404–3410. DOI: 10.1210/jc.2006-0614.
7. Ткачева О.Н., Рунихина Н.К., Котовская Ю.В., и др. Ведение пациентов со старческой астенией в первичном звене здравоохранения. Учебное пособие для врачей. Москва, 2016.
8. Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type2 diabetes–a meta-analysis. Osteoporos Int. 2006; 18(4): 427–444. DOI: 10.1007/s00198-006-0253-4.
9. Roux J.P., Wegrzyn J., Boutroy S., et al. The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex vivo study. Osteoporos Int. 2013; 24(9): 2455–2460. DOI: 10.1007/s00198-013-2316-7.
10. Kurra S., Fink D.A., Siris E.S. Osteoporosis-associated fracture and diabetes. Endocrinol Metab Clin North Am. 2014; 43(1): 233–43. DOI: 10.1016/j.ecl.2013.09.004.
11. Остеопороз. Учебно-методическое пособие для врачей, клинических ординаторов, интернов. А.М. Мкртумян, Е.В. Бирюкова, Л.В. Лигшатян. Москва, 2018, 162 с.
12. Ferrari S.L., Abrahamsen B., Napoli N., et al. Diagnosis and management of bone fragility in diabetes: an emerging challenge. Osteoporos Int. 2018; 29(12): 2585–2596. DOI: 10.1007/s00198-018-4650-2.
13. Schacter G.I., Leslie W.D. DXA-Based Measurements in Diabetes: Can They Predict Fracture Risk? Calcif Tissue Int. 2017; 100(2): 150–164. DOI: 10.1007/s00223-016-0191-x.
14. Leslie W.D., Aubry-Rozier B., Lamy O., et al. TBS (trabecular bone score) and diabetes-related fracture risk. J Clin Endocrinol Metab. 2013; 98(2): 602–9. DOI: 10.1210/jc.2012-3118.
15. Sugimoto K., Tabara Y., Ikegami H., et al. Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The MUSCLES-DM study. J Diabetes Investig. 2019; May 9. [Epub ahead of print]. DOI: 10.1111/jdi.13070.
16. Paschou S.A., Dede A.D., Anagnostis P.G., et al. Type 2 Diabetes and Osteoporosis: A Guide to Optimal Management. J Clin Endocrinol Metab. 2017; 102(10): 3621–3634. DOI: 10.1210/jc.2017-00042.
17. Shamliyan T., Talley K.M., Ramakrishnan R., Kane R.L. Association of frailty with survival: a systematic literature review. Ageing Res Rev. 2013; 12: 719–36. DOI: 10.1016/j.arr.2012.03.001.
18. Cesari M., Prince M., Thiyagarajan J.A., De Carvalho I.A., Bernabei R., et al. Frailty: an emerging public health priority. J Am Med Dir Assoc. 2016; 17(3): 188–192. DOI: 10.1016/j.jamda.2015.12.016.
19. Blakytny R., Spraul M., Jude E.B. Review: The Diabetic Bone: A Cellular and Molecular Perspective. The International Journal of Lower Extremity Wounds. 2011; 10(1): 16–32. DOI: 0.1177/1534734611400256.
20. Gonnelli S., Caffarelli C., Giordano N., Nuti R. The prevention of fragility fractures in diabetic patients. Aging Clin Exp Res. 2014; 27(2): 115–124. DOI: 10.1007/s40520-014-0258-3.
21. Jilka R.L. Molecular and cellular mechanisms of the anabolic effect of intermittent PTH. Bone. 2007; 40: 1434–46. DOI: 10.1016/j.bone.2007.03.017.
Review
For citations:
Brailova N.V., Dudinskaya E.N., Machekhina L.V., Tkacheva O.N. Diagnosis and treatment of osteoporosis in elderly patients with type 2 diabetes. Russian Journal of Geriatric Medicine. 2020;(2):159-164. (In Russ.) https://doi.org/10.37586/2686-8636-2-2020-159-164
Views:
865
Email this article 