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Background <p>While cardiovascular complications are a well-recognized consequence of type 2 diabetes, skeletal complications such as osteoporosis and fragility&#xa0;fractures remain under-recognized and under-treated. Individuals with long-standing diabetes face increased fracture risk due to poor bone quality,&#xa0;peripheral neuropathy, and a higher propensity to fall. Despite this, osteoporosis treatment rates in diabetic individuals sustaining fractures remain&#xa0;alarmingly low.</p> Objective <p>To highlight the unmet need for integrating bone health into diabetes care by examining the current gaps in awareness, diagnosis, and management of&#xa0;osteoporosis in individuals with type 2 diabetes, and to propose strategies for a more holistic clinical approach.</p> Methods <p>This narrative synthesis draws upon epidemiological evidence, treatment trends, and health system-level observations to describe the current status of&#xa0;osteoporosis care in diabetes and identify systemic barriers to effective fracture prevention.</p> Results <p>Fewer than 10% of people with diabetes who sustain fragility fractures receive appropriate osteoporosis treatment, despite near-universal access to&#xa0;cardiovascular interventions. This disparity is attributed to limited provider and patient awareness, fragmented care pathways, and insufficient public&#xa0;health emphasis on bone health in diabetes management.</p> Conclusion <p>There is an urgent need to integrate bone health assessments into routine diabetes care. This requires enhanced awareness, interdisciplinary&#xa0;collaboration among diabetologists, endocrinologists, orthopedicians, and primary care providers, and the development of specific guidelines addressing&#xa0;skeletal complications in diabetes. Prioritizing bone health alongside cardiovascular and metabolic care may significantly improve patient outcomes and&#xa0;reduce long-term healthcare costs.</p>

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Prioritizing the heart, neglecting the bones: The hidden impact of diabetes on skeletal health

  • 期刊论文

  • 发表日期：

    2025年8月9日

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  • Lakshmi Nagendra,
  • Saptarshi Bhattacharya,
  • Amit Gupta,
  • Kripa Cherian,
  • Sanjay Agarwal,
  • Deep Dutta,
  • Sunetra Mondal,
  • Ajay Hanumanthu,
  • Rakesh Sahay

摘要

Background

While cardiovascular complications are a well-recognized consequence of type 2 diabetes, skeletal complications such as osteoporosis and fragility fractures remain under-recognized and under-treated. Individuals with long-standing diabetes face increased fracture risk due to poor bone quality, peripheral neuropathy, and a higher propensity to fall. Despite this, osteoporosis treatment rates in diabetic individuals sustaining fractures remain alarmingly low.

Objective

To highlight the unmet need for integrating bone health into diabetes care by examining the current gaps in awareness, diagnosis, and management of osteoporosis in individuals with type 2 diabetes, and to propose strategies for a more holistic clinical approach.

Methods

This narrative synthesis draws upon epidemiological evidence, treatment trends, and health system-level observations to describe the current status of osteoporosis care in diabetes and identify systemic barriers to effective fracture prevention.

Results

Fewer than 10% of people with diabetes who sustain fragility fractures receive appropriate osteoporosis treatment, despite near-universal access to cardiovascular interventions. This disparity is attributed to limited provider and patient awareness, fragmented care pathways, and insufficient public health emphasis on bone health in diabetes management.

Conclusion

There is an urgent need to integrate bone health assessments into routine diabetes care. This requires enhanced awareness, interdisciplinary collaboration among diabetologists, endocrinologists, orthopedicians, and primary care providers, and the development of specific guidelines addressing skeletal complications in diabetes. Prioritizing bone health alongside cardiovascular and metabolic care may significantly improve patient outcomes and reduce long-term healthcare costs.