[Diabetes Mellitus and bone metabolism].

Deranged bone metabolism including osteoporosis is now clinically recognized as one of the diabetic complications. Diabetes could affect bone through multiple mechanisms, insulin deficiency, insulin resistance, hyperglycemia, atherosclerosis, etc. However, the exact mechanisms by which bone derangement is brought about in diabetes are yet unknown. In type 2 diabetes, fracture risk is increased despite high bone mineral density (BMD) through deteriorated "bone quality" , of which assessment is clinically difficult. Thus, it would be important for physicians to recognize diabetes as a fracture risk, and to assess each patient's fracture risk using available tools i.e. BMD, metabolic bone markers, etc. Intense treatment for osteoporosis is warranted in diabetics who have other established fracture risks such as those with prevalent fractures or postmenopausal state.