Type 2 Diabetes Mellitus: Existing Understanding and Expectations in India

Abstract

Increased fracture risk, which has been connected to type 1 diabetes in the past, has now become a top concern for those with type 2 diabetes. Depending on where the bone is located, how long you've had diabetes, and the study techniques, there has been evidence of a varying increase in fracture risk, ranging from 20% to 3-fold. An increased risk of fracture has been associated with a longer disease course, diabetes comorbidities, inadequate glycemic control, insulin use, and a higher risk of falling. With either normal or higher bone mineral density and changed structural and geometric characteristics, Type 2 diabetic individuals have a unique skeletal phenotype. The most frequent issue in recent years, which increases bone fragility, seems to be changes in the properties of bone material. The slowdown of bone turnover, the accumulation of advanced glycation end products, and modifications in collagen cross-linking all appear to be harmful to bone strength. While lumbar spine BMD has been proved to be ineffective for predicting vertebral fractures, the FRAX score has been shown to understate fracture risk. Anti-diabetic medications, with the exception of thiazolidinediones, are safe for the skeleton, while more research is required. There is further research needed to determine the best approaches to reduce bone fragility in type 2 diabetes.