‘Don’t break a leg!’ – Osteoporosis and bone health matters in diabetes

‘Don’t break a leg!’ – Osteoporosis and bone health matters in diabetes

The interplay between diabetes and osteoporosis is clinically meaningful. Increasingly this is now being appreciated in clinical research in part owing to their shared pathophysiological mechanisms and cumulative health impact.

In essence, both are prevalent chronic conditions, often coexisting in ageing populations. That said, there is a fast-emerging increasing incidence of osteoporosis in younger and pre-menopausal populations. Historically, osteoporosis has been perceived primarily as a women’s health issue, resulting in potentially significantgender biases in screening practices. Men also face substantial risks, particularly in older age or in the presence of secondary causes of bone loss such as hypogonadism. This bias in screening practices has led to delayed diagnosis and suboptimal management in men, highlighting the need for a more inclusive approach to osteoporosis screening.

The implications for daily practice can be particularly recognized after a fracture has occurred. Increased mortality and reduced functional independence are well known post-fracture consequences.  Additionally, diabetes further complicates recovery from fractures, being associated with delayed healing and a higher susceptibility to infections. This underscores the need for early identification and management of osteoporosis in people with diabetes before a fracture manifests.