Endocrine Abstracts

In patients with type 2 diabetes mellitus (T2DM), the question of the magnitude of loss of BMD and the risk of fracture is discussed.

Objective: To study the relationship between the BMD deficiency in patients with type 2 diabetes with the risk of fracture of the distal radius.

Materials and methods: A comparative study of the loss of BMD in patients with fracture of the radial bone with type 2 diabetes mellitus and without diabetes mellitus was carried out. The study included 118 patients with type 2 diabetes mellitus and 175 patients not suffering from type 2 diabetes mellitus. The distribution by age in the groups was identical. The patients were sampled according to the city trauma clinic. The study included patients 50 years and older with a fracture of the distal forearm. All patients underwent X-ray densitometry on the DTX-200 device provided by Nicomed Takeda.

Results of the study: Depending on the magnitude of loss of BMD by T-test, patients were divided into 4 groups: 1 group, without loss of BMD; from 0 and above: 50.0% with T2DM; 19.4% without T2DM; 2 group - loss of BMD to - 1 SD: from 0 to −1.0: 15.3% with T2DM; 21.7% without T2DM; 3 group - loss of BMD from −1.0 to −2.5 SD: 19.0% with T2DM; 29.0% without T2DM; 4 group-loss exceeded −2.5 SD: 15.3% with T2DM; 29.7% without T2DM. As can be seen from the presented, in 65.3% of patients with T2DM low-energy fractures of the radial bone occur at normal or slightly decreased BMD values. While, in patients without diabetes mellitus, this loss is observed in 41.1%. Loss of BMD −2.5 SD and lower occurred in 15.3% of patients with type 2 diabetes mellitus and 29.7% without this pathology.

Conclusion: The obtained data give grounds to believe that in the case of type 2 diabetes in most patients, the leading factor in reducing bone strength and fracture risk is not a loss of BMD, but a violation of its quality due to a decrease in the intensity of remodeling and accumulation of the ‘old’ hypermineralized bone.