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Type 1 Diabetes and Bone Fragility: Links and Risks

Authors Starup-Linde J, Hygum K, Harsløf T, Langdahl B

Received 20 August 2019

Accepted for publication 19 November 2019

Published 3 December 2019 Volume 2019:12 Pages 2539—2547


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Jing Sun

Jakob Starup-Linde,1–3 Katrine Hygum,1 Torben Harsløf,1 Bente Langdahl1

1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; 2Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; 3Department of Medicine, Region Hospital Horsens, Aarhus, Denmark

Correspondence: Jakob Starup-Linde
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, Aarhus N DK-8200, Denmark
Tel +45 29926952

Abstract: Type 1 diabetes (T1D) is associated with an increased fracture risk, which is present at young and old age. Reductions in bone mineral density do not explain the increased fracture risk. Novel scanning modalities suggest that structural deficits may contribute to the increased fracture risk. Furthermore, T1D may due to insulinopenia be a state of low bone turnover. However, diabetes complications and comorbidities may influence fracture risk. Patients with T1D are fearful of falls. The diabetes related complications, hypoglycemic events, and antihypertensive treatment may all lead to falls. Thus, the increased fracture risk in T1D seems to be multifactorial, and earlier intervention with antiosteoporotic medication and focus on fall prevention is needed. This systematic review addresses the epidemiology of fractures and osteoporosis in patients with T1D and the factors that influence fracture risk.

Keywords: type 1 diabetes, osteoporosis, fracture, falls, bone mineral density

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