Tip 1 Diyabet ve Osteoporoz

ÖzTip 1 Diyabet mellitus (DM) hastalarında uzamış yaşam beklentisi ile kardiyovasküler hastalıklar, osteoporoz ve kognitif bozulmalar gibi yaşa bağlı gelişebilecek komplikasyolar daha çok önem kazanmaya başlamıştır. Tip 1 Dm ve osteoporoz ilişkisi oldukça karmaşık olup bu konuda yapılmış pek çok çalışma bulunmaktadır. Glisemik kontrol ve uzun süreli diyabetin, düşük kemik mineral yoğunluğu (KMD) ve kemik fraktür riski ile ilişkili olduğu bilinmektedir. AyrıcaTip 1 diyabetteki mevcut insulin eksikliğinin kemik yapısının oluşumu üzerinenegatif etkisi olduğu da ileri sürülmüştür. Sonuç olarak tıpkı Tip 2 Dm olduğugibi Tip 1 DM hastalarında da osteoporoz riski normal popülasyondan yüksektir ve tanı koymada gecikme yaşanmaktadır. Bu nedenle yaşam beklentisi uza-mış olan Tip 1 DM’li hasta grubunda bu hastalığın erken tanınıp tedavi edilmesinin önemli bir komorbidite olan fraktür riskinde azalmaya neden olacağı düşünülmektedir.

Anahtar Kelimeler:

Tip 1 diyabet, osteoporoz, kırık

Type 1 Diabetes and Osteoporosis

AbstractThe complications like cardiovascular diseases, osteoporosis and conginif detoriations that are seen in elderly has became more important as the increase oflong life expactance among Type 1 Diabetes mellitus (DM). It is very well known that long duration of diabetes and glisemic control is associated with bone mineral density and bone fragility risk. Also insüline deficiency in Type 1 DM isprovided to be a negative factor on bone stracture. As a result likely in Type 2DM, osteoporosis is more common among Type 1 DM than normal population and diagnosis delates. It is been thougt that the early diagnosis and teratment ofosteoporosis may decrease the risk of fracture which is an important comorbidite, in Type 1 diabetic patients.

Keywords:

Type 1 diabetes mellitus, osteoporosis, fracture,

PDF

___

Kaynaklar 1.Shah VN, Shah CS, Snell-Bergeon JK. Type 1 diabetesand risk of fracture: meta-analysis and review of the li-terature. Diabet Med. 2015;32(9):1134-42. 2.Shah VN, Moser EG, Blau A, Dhingra M, Garg SK. Thefuture of basal insulin. Diabetes Technol Ther.2013;15(9):727-32. 3.Atkinson MA, Eisenbarth GS, Michels AW. Type 1 dia-betes. Lancet. 2014;383(9911):69-82. 4.Miller RG, Secrest AM, Sharma RK, Songer TJ, OrchardTJ. Improvements in the life expectancy of type 1 diabe-tes: the Pittsburgh Epidemiology of Diabetes Complica-tions study cohort. Diabetes. 2012;61(11): 2987-92. 5.Alexopoulou O, Jamart J, Devogelaer JP, Brichard S,de Nayer P, Buysschaert M. Bone density and markersof bone remodeling in type 1 male diabetic patients. Dia-betes Metab. 2006;32(5 Pt 1):453-8. 6.Hadjidakis DJ, Raptis AE, Sfakianakis M, Mylonakis A,Raptis SA. Bone mineral density of both genders in Type1 diabetes according to bone composition. J DiabetesComplications. 2006;20(5):302-7. 7.Vestergaard P. Discrepancies in bone mineral density andfracture risk in patients with type 1 and type 2 diabetes--a meta-analysis. Osteoporos Int. 2007;18(4):427-44. 8.Liu EY, Wactawski-Wende J, Donahue RP, Dmochows-ki J, Hovey KM, Quattrin T. Does low bone mineral den-sity start in post-teenage years in women with type 1 dia-betes? Diabetes Care. 2003;26(8):2365-9. 9.Rakic V, Davis WA, Chubb SA, Islam FM, Prince RL,Davis TM. Bone mineral density and its determinantsin diabetes: the Fremantle Diabetes Study. Diabetolo-gia. 2006;49(5):863-71. 10.Lunt H, Florkowski CM, Cundy T, Kendall D, BrownLJ, Elliot JR, et al. A population-based study of bonemineral density in women with longstanding type 1 (in-sulin dependent) diabetes. Diabetes Res Clin Pract.1998;40(1):31-8. 11.Olmos JM, Perez-Castrillon JL, Garcia MT, Garrido JC,Amado JA, Gonzalez-Macias J. Bone densitometry and bi-ochemical bone remodeling markers in type 1 diabetes mel-litus. Bone Miner. 1994;26(1):1-8. 12.Rozadilla A, Nolla JM, Montana E, Fiter J, Gomez-Va-quero C, Soler J, et al. Bone mineral density in patientswith type 1 diabetes mellitus. Joint Bone Spine.2000;67(3):215-8. 13.Kurra S, Siris E. Diabetes and bone health: the relati-onship between diabetes and osteoporosis-associatedfractures. Diabetes Metab Res Rev. 2011;27(5):430-5. 14.DeShields SC, Cunningham TD. Comparison of osteo-porosis in US adults with type 1 and type 2 diabetes mel-litus. J Endocrinol Invest. 2018. 15.Roy B. Biomolecular basis of the role of diabetes mel-litus in osteoporosis and bone fractures. World J Dia-betes. 2013;4(4):101-13. 16.de L, II, van der Klift M, de Laet CE, van Daele PL, Hof-man A, Pols HA. Bone mineral density and fracture riskin type-2 diabetes mellitus: the Rotterdam Study. Osteo-poros Int. 2005;16(12):1713-20. 17.Leidig-Bruckner G, Grobholz S, Bruckner T, Scheidt-Nave C, Nawroth P, Schneider JG. Prevalence and de-terminants of osteoporosis in patients with type 1 andtype 2 diabetes mellitus. BMC Endocr Disord.2014;14:33. 18.Neumann T, Samann A, Lodes S, Kastner B, Franke S,Kiehntopf M, et al. Glycaemic control is positively as-sociated with prevalent fractures but not with bone mi-neral density in patients with Type 1 diabetes. DiabetMed. 2011;28(7):872-5. 19.Vestergaard P, Rejnmark L, Mosekilde L. Diabetes andits complications and their relationship with risk of frac-tures in type 1 and 2 diabetes. Calcif Tissue Int.2009;84(1):45-55. 20.Ahmed LA, Joakimsen RM, Berntsen GK, Fonnebo V,Schirmer H. Diabetes mellitus and the risk of non-ver-tebral fractures: the Tromso study. Osteoporos Int.2006;17(4):495-500. 21.Heath H, 3rd, Melton LJ, 3rd, Chu CP. Diabetes mel-litus and risk of skeletal fracture. N Engl J Med.1980;303(10):567-70. 22.Janghorbani M, Van Dam RM, Willett WC, Hu FB. Syste-matic review of type 1 and type 2 diabetes mellitus andrisk of fracture. Am J Epidemiol. 2007;166(5) :495-505. 23.Schwartz AV, Vittinghoff E, Bauer DC, Hillier TA, Strot-meyer ES, Ensrud KE, et al. Association of BMD andFRAX score with risk of fracture in older adults with type2 diabetes. JAMA. 2011;305(21):2184-92. 24.Kanis JA, Johnell O, Oden A, Johansson H, McCloskeyE. FRAX and the assessment of fracture probability inmen and women from the UK. Osteoporos Int.2008;19(4):385-97. 25.Mastrandrea LD, Wactawski-Wende J, Donahue RP, Ho-vey KM, Clark A, Quattrin T. Young women with type1 diabetes have lower bone mineral density that persistsover time. Diabetes Care. 2008;31(9):1729-35. 26.Diabetes and Metabolic Bone Health, Meet the profes-sor clinical case management, ENDO, 2017, 63-65. 27.Vestergaard P, Rejnmark L, Mosekilde L. Are antire-sorptive drugs effective against fractures in patients withdiabetes? Calcif Tissue Int. 2011;88(3):209-14.