Critical review of bone health, fracture risk and management of bone fragility in diabetes mellitus

Figure 4 Evaluation of fracture risk in patients with type 2 diabetes mellitus. ¹: ≥ 1 nonvertebral nonhip fragility fracture might be required to initiate therapy; ²: Diabetes-specific clinical risk factors (diabetes duration, antidiabetic medications,, hemoglobin A1c and microvascular complications); ³: In diabetes, fracture risk at T-score < -2 equivalent for nondiabetes at T-score < -2.5; ⁴: See text. CRF: Clinical risk factor; TBS: Trabecular bone score; DXA: Dual energy X-ray absorptiometry; T2DM: Type 2 diabetes mellitus; FRAX: Fracture Risk Assessment Tool; H/o: History of. Modified from Ferrari et al[123]: Ferrari SL, Abrahamsen B, Napoli N, Akesson K, Chandran M, Eastell R, El-Hajj Fuleihan G, Josse R, Kendler DL, Kraenzlin M, Suzuki A, Pierroz DD, Schwartz AV, Leslie WD; Bone and Diabetes Working Group of IOF. Diagnosis and management of bone fragility in diabetes: an emerging challenge. Osteoporos Int 2018; 29:2585-2596.Copyright ©The Author(s) 2018. Published by Springer Nature.