Bone microarchitecture and strength assessed by HRpQCT in individuals with type 2 diabetes and prediabetes: the Maastricht study.

Type 2 diabetes (T2D) is a prevalent disease and has been associated with an increased fracture risk despite normal or even higher areal BMD. The aim of this study was to estimate the association between glucose metabolism status (GMS) and measurements of glycemic control with HRpQCT parameters of bone microarchitecture and strength. Participants of the Maastricht study who underwent an HRpQCT scan at the distal radius and tibia were included.

Fracture patterns and associated risk factors in pediatric and early adulthood type 1 diabetes: Findings from a nationwide retrospective cohort study.

Purpose: People with pediatric and early adulthood type 1 diabetes (T1D) might have a higher fracture risk at several sites compared to the general population. Therefore, we assessed the hazard ratios (HR) of various fracture sites and determined the risk factors associated with fractures among people with newly diagnosed childhood and adolescence T1D.

Methods: All people from the UK Clinical Practice Research Datalink GOLD (1987-2017), below 20 years of age with a T1D diagnosis code (n = 3100) and a new insulin prescription, were included and matched 1:1 by sex, age, and practice to a control without diabetes.

Effects of Incretin Therapy on Skeletal Health in Type 2 Diabetes-A Systematic Review.

Diabetes poses a significant risk to bone health, with Type 1 diabetes (T1D) having a more detrimental impact than Type 2 diabetes (T2D). The group of hormones known as incretins, which includes gastric inhibitory peptide (GIP) and glucagon-like peptide 1 (GLP-1), play a role in regulating bowel function and insulin secretion during feeding. GLP-1 receptor agonists (GLP-1 RAs) are emerging as the primary treatment choice in T2D, particularly when atherosclerotic cardiovascular disease is present.

Fracture patterns in adult onset type 1 diabetes and associated risk factors - A nationwide cohort study.

Objective: This study aimed to determine the hazard ratios (HR) for various fracture sites and identify associated risk factors in a cohort of relatively healthy adult people with newly diagnosed type 1 diabetes (T1D).

Methods: The study utilized data from the UK Clinical Practice Research Datalink GOLD (1987-2017). Participants included people aged 20 and above with a T1D diagnosis code (n = 3281) and a new prescription for insulin.

The co-existence of peripheral and vestibular neuropathy in diabetes: a cross-sectional study.

Purpose: Diabetic neuropathy can lead to decreased peripheral sensation and motor neuron dysfunction associated with impaired postural control and risk of falling. However, the relationship between decreased peripheral sensation and impaired vestibular function in diabetes mellitus is poorly investigated. Therefore, the aim of this study was to investigate the relationship between peripheral and autonomic measurements of diabetic neuropathy and measurements of vestibular function.

Bone parameters in T1D and T2D assessed by DXA and HR-pQCT - A cross-sectional study: The DIAFALL study.

Introduction/aim: People with type 1 diabetes (T1D) and type 2 diabetes (T2D) have an increased risk of fractures due to skeletal fragility. We aimed to compare areal bone mineral density (aBMD), volumetric BMD (vBMD), cortical and trabecular measures, and bone strength parameters in participants with diabetes vs. controls.

Impaired postural control in diabetes-a predictor of falls?

Unlabelled: New evidence points toward that impaired postural control judged by center of pressure measures during quiet stance is a predictor of falls in people with type 1 and type 2 diabetes-even in occurrence of well-known risk factors for falls.

Introduction/aim: People with type 1 diabetes (T1D) and type 2 diabetes (T2D) are at risk of falling, but the association with impaired postural control is unclear. Therefore, the aim was to investigate postural control by measuring the center of pressure (CoP) during quiet standing and to estimate the prevalence ratio (PR) of falls and the fear of falling among people with diabetes compared to controls.

Diabetes and osteoporosis - Treating two entities: A challenge or cause for concern?

People with T1D and T2D have an increased risk of fractures than the general population, posing several significant pathophysiologic, diagnostic, and therapeutic challenges. The pathophysiology is still not fully elucidated, but it is considered a combination of increased skeletal fragility and falls. Diagnostics issues exist, as regular and even newer scan methods underestimate the true incidence of osteoporosis and thus the fracture risk.

The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus.

Purpose: In this descriptive study, we examined the incidence of fractures in patients with newly treated type 2 diabetes mellitus (T2D) compared to matched reference population.

Methods: Participants from the UK Clinical Practice research datalink (CPRD) GOLD (1987-2017), aged ≥30 years, with a T2D diagnosis code and a first prescription for a non-insulin anti-diabetic drug (n = 124,328) were included. Cases with T2D were matched by year of birth, sex and practice to a reference population (n = 124,328), the mean follow-up was 7.

Is predicted body-composition and relative fat mass an alternative to body-mass index and waist circumference for disease risk estimation?

Background And Aims: New methods to estimate body-composition have recently been proposed, but their relation to diseases, such as diabetes and coronary heart disease, needs further investigation. The purpose of this study was to investigate the association between proposed prediction of body-composition (PBC); Relative Fat Mass (RFM), Body Mass Index (BMI), Waist Circumference (WC) and disease.

Methods: In a cross-sectional cohort (NHANES) the association between the four body measures and diabetes, high blood pressure, coronary heart disease, cancer, arthritis, and hospitalization were assessed.

Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study.

Background: Type 2 diabetes (T2D) is frequently reported to be associated with an increased fracture risk. Epidemiological data on prevalent morphometric vertebral fractures (VFs) in T2D are sparse and even less is known in the prediabetic state.

Purpose: To determine the association between prevalence and severity of morphometric VFs and glucose metabolism state: normal glucose metabolism (NGM), impaired glucose metabolism (prediabetes) or T2D.

Fracture Patterns in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review of Recent Literature.

Purpose Of Review: In this narrative review, we have summarized the literature on fracture risk in T1DM and T2DM with a special focus on fracture site, time patterns, glucose-lowering drugs, and micro- and macrovascular complications.

Recent Findings: T1DM and T2DM were associated with an overall increased fracture risk, with preferent locations at the hip, vertebrae, humerus, and ankle in T1DM and at the hip, vertebrae, and likely humerus, distal forearm, and foot in T2DM. Fracture risk was higher with longer diabetes duration and the presence of micro- and macrovascular complications.

Precise Prediction of Total Body Lean and Fat Mass From Anthropometric and Demographic Data: Development and Validation of Neural Network Models.

Background: Estimating body composition is relevant in diabetes disease management, such as drug administration and risk assessment of morbidity/mortality. It is unclear how machine learning algorithms could improve easily obtainable body muscle and fat estimates. The objective was to develop and validate machine learning algorithms (neural networks) for precise prediction of body composition based on anthropometric and demographic data.

Increased Risk of Falls, Fall-related Injuries and Fractures in People with Type 1 and Type 2 Diabetes - A Nationwide Cohort Study.

Introduction: People with diabetes could have an increased risk of falls as they show more complications, morbidity and use of medication compared to the general population. This study aimed to estimate the risk of falls and to identify risk factors associated with falls in people with diabetes. The second aim was to estimate fall-related injuries, such as lesions and fractures, including their anatomic localization in people with diabetes compared with the general population.

Falls and Fractures in Diabetes-More than Bone Fragility.

Purpose Of Review: Based on a systematic literature search, we performed a comprehensive review of risk factors for falls and fractures in patients with diabetes.

Recent Findings: Patients with diabetes have an increased risk of fractures partly explained by increased bone fragility. Several risk factors as altered body composition including sarcopenia and obesity, impaired postural control, gait deficits, neuropathy, cardiovascular disease, and other co-morbidities are considered to increase the risk of falling.

Validity of diagnostic coding for undernutrition in hospitals.

Background & Aims: We examined the accuracy of ICD-10 diagnostic coding for undernutrition in Danish Hospitals, including the use of Nutritional Risk Screening 2002 guidelines.

Methods: We investigated a random sample of hospitalized patients registered in the Danish National Registry of Patients with a discharge diagnosis of undernutrition between 2002 and 2011 in the North Denmark Region. Based on medical record review we estimated the positive predictive value (PPV) of the undernutrition diagnosis.