Nagendra Lakshmi, Agarwal Khushboo, Patra Shinjan, Bhattacharya Saptarshi, Gupta Latika, Talwar Nishka, Rao Aditya, Gupta Amit, Kamrul-Hasan A B M, Dutta Deep, Hiligsmann Mickael, Chandran Manju
Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Curr Diab Rep. 2025 Jul 21;25(1):43. doi: 10.1007/s11892-025-01599-x.
In this review, we explore the under-recognized burden of fractures in diabetes, focusing on resource-constrained healthcare systems. We examine the epidemiology, assessment methodologies, and management approaches to osteoporosis in diabetes and discuss strategies to improve skeletal health outcomes.
Public healthcare strategies for fracture risk reduction in diabetes include educating healthcare providers, empowering patients, and integrating fracture liaison services for secondary prevention. Community-based awareness programs, digital health solutions, and screening tools such as FRAX® (with diabetes-specific adjustments) facilitate early identification and management. Policies supporting insurance coverage and cost-effective management strategies are likewise crucial. Diabetes-related bone fragility, characterized by altered bone quality and increased fracture risk despite relatively preserved bone density, creates a significant yet underrecognized health burden. Fracture prevention in diabetes is both a clinical necessity and an economic imperative. In this expanding cohort, multidisciplinary, policy-supported strategies can reduce morbidity, mortality, and costs associated with fragility fractures.
在本综述中，我们探讨糖尿病患者中未得到充分认识的骨折负担，重点关注资源有限的医疗保健系统。我们研究糖尿病患者骨质疏松症的流行病学、评估方法和管理方法，并讨论改善骨骼健康结果的策略。
糖尿病患者降低骨折风险的公共卫生保健策略包括对医疗保健提供者进行教育、增强患者能力以及整合骨折联络服务以进行二级预防。基于社区的提高认识项目、数字健康解决方案以及如FRAX®（进行糖尿病特异性调整）等筛查工具有助于早期识别和管理。支持保险覆盖和具有成本效益的管理策略的政策同样至关重要。糖尿病相关的骨脆性，其特征是尽管骨密度相对保持，但骨质量改变且骨折风险增加，造成了重大但未得到充分认识的健康负担。糖尿病患者的骨折预防既是临床必需，也是经济上的迫切需求。在这个不断扩大的人群中，多学科、政策支持的策略可以降低与脆性骨折相关的发病率、死亡率和成本。
