Abstract
The effect of impaired regulation of the glucose metabolism on the bone tissue metabolism is many-sided and very complicated. In most cases we observe an increased risk of fracture in people with diabetes.
The reasons causing this condition are varied. Its main cause in diabetic patients is typically not the decrease in bone mineral density, it is rather deterioration of bone tissue and its structure.
An important role of insulin and insulin resistance is beyond dispute, with numerous other factors at work, such as increased glycation of proteins, including increased glycation of collagen in bones, change in sclerostin production and levels, intervention in the pluripotent stem cells differentiation and reversal of their differentiation toward adipocytes and many more. Some antidiabetics, mainly oral, may also significantly contribute to the increased risk of fracture.
Given the increasing incidence of both diseases, diabetes and osteoporosis, it will be also necessary to examine in greater detail their mutual relations and effects.