Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2021; 12(6): 706-729
Published online Jun 15, 2021. doi: 10.4239/wjd.v12.i6.706
Critical review of bone health, fracture risk and management of bone fragility in diabetes mellitus
Rajan Palui, Subhodip Pramanik, Sunetra Mondal, Sayantan Ray
Rajan Palui, Department of Endocrinology, The Mission Hospital, Durgapur 713212, West Bengal, India
Subhodip Pramanik, Department of Endocrinology, Neotia Getwel Healthcare Centre, Siliguri 734010, West Bengal, India
Sunetra Mondal, Department of Endocrinology, Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata 700020, West Bengal, India
Sayantan Ray, Department of Endocrinology, Medica Superspeciality Hospital and Medica Clinic, Kolkata 700099, West Bengal, India
Sayantan Ray, Department of Endocrinology, Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata 700137, West Bengal, India
Author contributions: Palui R performed the literature search, wrote the first draft and provided intellectual input; Pramanik S and Mondal S conceptualized the work, performed a literature search, supervised the writing, provided intellectual input and critically revised the manuscript; Ray S supervised the literature search and the writing, provided intellectual input and critically revised the manuscript.
Conflict-of-interest statement: Nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sayantan Ray, MBBS, MD, Department of Endocrinology, Medica Superspeciality Hospital and Medica Clinic, 127, EM Bypass, Mukundapur, Kolkata 700099, West Bengal, India. sayantan.ray30@gmail.com
Received: January 27, 2021
Peer-review started: January 27, 2021
First decision: March 30, 2021
Revised: April 8, 2021
Accepted: April 29, 2021
Article in press: April 29, 2021
Published online: June 15, 2021
Processing time: 127 Days and 24 Hours
Core Tip

Core Tip: Diabetes mellitus, either type 1 or type 2, has adverse effects on bone that translate into an elevated fracture risk. Different pathophysiological mechanisms contribute to poor bone health in patients with diabetes. Diagnosis of bone fragility in diabetic patients is challenging as traditional fracture predictors underestimate fracture risk in this population, contributing to the concept that diabetes affects bone quality. While waiting for further evidence, the prevention and management of bone fragility in diabetes should include identification of patients at risk, correction of modifiable risk factors, appropriate choice of antidiabetic medications and use of antiosteoporosis drugs with proven efficacy.