osteoporosis, diabetes mellitus, FRAX, bisphosphonates, calcium, vitamin D.


The number of patients with diabetes mellitus in the world has been progressively increasing in recent years, therefore, the fight against complications of diabetes mellitus is an important problem of our time. The purpose of our review is to analyze the literature data on the risks of osteoporosis in patients with diabetes mellitus, effective diagnostic methods, as well as current recommendations for the treatment and prevention of osteoporosis in this category of patients. Results. We have processed and analyzed literary sources and international
recommendations, which identify the main mechanisms and risk factors that contribute to the development of osteoporosis in patients with type 1 and 2 diabetes mellitus; methods for the timely diagnosis of osteoporosis are indicated, methods for correcting the condition of patients with diabetes mellitus, which can help prevent the development of osteoporosis in this group of patients, are given. The current recommendations for the treatment of osteoporosis in men and women are presented. Conclusions. Taking into account the data of the analysis of literary sources, osteoporosis can be considered one of the complications of diabetes mellitus. Today, densitometry and fracture risk assessment FRAX are quite sensitive methods for early diagnosis of osteoporosis in patients with type 1 diabetes mellitus, but not sufficient for patients with type 2 diabetes mellitus, therefore there is a need to determine the trabecular bone index during densitometry, as well as additional actions when assessing the risk of fractures on the FRAX scale. Therapy of patients with osteoporosis with concomitant diabetes mellitus should be based on the achievement of target glycemic levels and the use of bisphosphonates with target level of calcium and vitamin D.


Polonsky KS, Burant CF. Chapter 31 – Type 2 Diabetes Mellitus, Williams Textbook of Endocrinology (Thirteenth Edition), Elsevier, 2016: 1385-1450. https://doi.org/10.1016/B978-0-323-29738-7.00031-9.

Mistyakov MV, Bardimova TP, Tsyretorova SS. Siberian Med J (Irkutsk) 2015; 6: 47-53.

Kuznetsova AF, Slobodenyuk TF. VI s'ezd terapevtov Zabaykalskogo kraya: Sbornik nauchnyih trudov, Chita, 22-23 marta 2018 g. Chita, 2018: 29-35, available at: https://chitgma.ru/vi-s-ezd-terapevtov-zabajkalskogo-kraya/4116/%D0%A1%D0%B1%D0%BE%D1%80%D0%BD%D0%B8%D0%BA.pdf.

Kovalenko VM, Shuba NM. Nacional’nyj pidruchnyk z revmatologii, Kyiv, 2013: 687 p.

Lesnyak OM, Benevolenskaya LI. Osteoporosis. 2-nd ed, Moskow, 2012: 272 p.

Grados F, Marcelli C, Dargent-Molina P, et al. Bone 2004; 34(2): 362-367. http://doi.org/10.1016/j.bone.2003.11.008.

Brailova NV, Dudinskaya EN, Machekhina LV, Tkacheva ON. Rus J Geriatric Med 2020; (2): 159-164.


Dedov II, Mel'nichenko GA, Belaia ZE, Rozhinskaia LI. Probl Endocrinol 2011; 57(1): 35-45. https://doi.org/10.14341/probl201157135-45.

Doskina EV. Endocrinology 2015; 11(2): 49-56.

Molitvoslovova NA, Galstyan GR. Diabetes Mellitus 2013; 16(1): 57-62. https://doi.org/10.14341/2072-0351-3598.

Kurra S, Fink DA, Siris ES. Endocrinol Metab Clin North Am 2 014; 4 3(1): 2 33-243. http://doi.org/10.1016/j.ecl.2013.09.004.

de Luis Román DA, Aller R, Perez Castrillon JL, et al. Ann Nutr Metab 2004; 48(3): 141-145. http://doi.org/10.1159/000078376.

Räkel A, Sheehy O, Rahme E, LeLorier J. Diabetes Metab 2008; 34(3): 193-205. http://doi.org/10.1016/j.diabet.2007.10.008.

Adami S. Curr Med Res Opin 2009; 25(5): 1057-1072. http://doi.org/10.1185/03007990902801147.

Epstein S, LeRoith D. Bone 2008; 43(1): 3-6. http://doi.org/10.1016/j.bone.2008.03.017.

Soccio RE, Chen ER, Lazar MA. Cell Metab 2014; 20(4): 573-591. http://doi.org/10.1016/j.cmet.2014.08.005.

Shah VN, Shah CS, Snell-Bergeon JK. Diabet Med 2015; 32(9): 1134-1142. http://doi.org/10.1111/dme.12734.

Thong EP, Herath M, Weber DR, et al. Clin Endocrinol (Oxf) 2 018; 8 9(3): 3 14-323. h ttp://doi.org/10.1111/cen.13761.

Vestergaard P, Rejnmark L, Mosekilde L. Diabetologia 2005; 48: 1292-1299. http://doi.org/10.1007/s00125-005-1786-3.

Janghorbani M, van Dam RM, Willett WC, et al. Am J Epidemiol 2007; 166: 495-505. http://doi.org/10.1093/aje/kwm106 43.

Vestergaard P. Osteoporos Int 2007; 18: 427-444. http://doi.org/10.1007/s00198-006-0253-4.

Leidig-Bruckner G, Grobholz S, Bruckner T, et al. BMC Endocr Disord 2014; 14: 33. http://doi.org/10.1186/1472-6823-14-33.

Jia P, Bao L, Chen H, et al. Osteoporos Int 2017; 28(11): 3113-3121. http://doi.org/10.1007/s00198-017-4183-0.

Moayeri A, Mohamadpour M, Mousavi SF, et al. Ther Clin Risk Manag 2017; 13: 455-468. http://doi.org/10.2147/TCRM.S131945.

Ni Y, Fan D. Medicine (Baltimore) 2017; 96(51): e8811. http://doi.org/10.1097/MD.0000000000008811.

Ivers RQ, Cumming RG, Mitchell P, Peduto AJ. Diabetes Care 2 001; 2 4(7): 1198-1203. http://doi.org/10.2337/diacare.24.7.1198.

Melton LJ, Leibson CL, Achenbach SJ, et al. J Bone Miner Res 2008; 23(8): 1334-1342. http://doi.org/10.1359/jbmr.080323.

Leslie WD, Lix LM, Prior HJ, et al. Bone 2007; 40(6): 1595-1601. http://doi.org/10.1016/j.bone.2007.02.021.

Li CI, Liu CS, Lin WY, et al. J Bone Miner Res 2015; 30(7): 1338-1346. http://doi.org/10.1002/jbmr.2462.

Losada E, Soldevila B, Ali MS, et al. Osteoporos Int 2018; 29(9): 2079-2086. http://doi.org/10.1007/s00198-018-4581-y.

Marin C, Luyten FP, Van der Schueren B, et al. Front Endocrinol (Lausanne) 2018; 9: 6. http://doi.org/10.3389/fendo.2018.00006.

Gortler H, Rusyn J, Godbout C, et al. Injury 2018; 49(2): 177-183. http://doi.org/10.1016/j.injury.2017.11.006.

Gilbert MP, Pratley RE. Endocr Rev 2015; 36(2): 194-213. http://doi.org/10.1210/er.2012-1042.

Picke AK, Campbell G, Napoli N, et al. Endocr Connect 2 019; 8 (3): R 55-R70. h ttp://doi.org/10.1530/EC-18-0456.

Sellmeyer DE, Civitelli R, Hofbauer LC, et al. Diabetes 2016; 65(7): 1757-1766. http://doi.org/10.2337/db16-0063.

Hygum K, Starup-Linde J, Harsløf T, et al. Eur J Endocrinol 2017; 176(3): R137-R157. http://doi.org/10.1530/EJE-16-0652.

Gregorio F, Cristallini S, Santeusanio F, et al. Diabetes Res Clin Pract 1994; 23(1): 43-54. http://doi.org/10.1016/0168-8227(94)90126-0.

Horcajada-Molteni MN, Chanteranne B, Lebecque P, et al. J Bone Miner Res 2001; 16(5): 958-965. http://doi.org/10.1359/jbmr.2001.16.5.958.

Dacquin R, Davey RA, Laplace C, et al. J Cell Biol 2004; 164(4): 509-514. http://doi.org/10.1083/jcb.200312135.

Farlay D, Armas LA, Gineyts E, et al. J Bone Miner Res 2016; 31(1): 190-195. http://doi.org/10.1002/jbmr.2607.

Napoli N, Chandran M, Pierroz DD, et al. Nat Rev Endocrinol 2017; 13(4): 208-219. http://doi.org/10.1038/nrendo.2016.153.

Rosen CJ, Ackert-Bicknell C, Rodriguez JP, et al. Crit Rev Eukaryot Gene Expr 2009; 19(2): 109-124. http://doi.org/10.1615/critreveukargeneexpr.v19.i2.20.

Baum T, Yap SP, Karampinos DC, et al. J Magn Reson Imaging 2 012; 3 5(1): 1 17-124. h ttp://doi.org/10.1002/jmri.22757.

Patsch JM, Li X, Baum T, et al. J Bone Miner Res 2013; 28(8): 1721-1728. http://doi.org/10.1002/jbmr.1950.

de Araújo IM, Salmon CE, Nahas AK, et al. Eur J Endocrinol 2 017; 1 76(1): 2 1-30. h ttp://doi.org/10.1530/EJE-16-0448.

Shanbhogue VV, Hansen S, Frost M, et al. Eur J Endocrinol 2016; 174(2): 115-124. http://doi.org/10.1530/EJE-15-0860.

Shanbhogue VV, Hansen S, Frost M, et al. J Bone Miner Res 2015; 30(12): 2188-2199. http://doi.org/10.1002/jbmr.2573.

Zeitz U, Weber K, Soegiarto DW, et al. FASEB J 2003; 17(3): 509-511. http://doi.org/10.1096/fj.02-0424fje.

Mathieu C, Gysemans C, Giulietti A, Bouillon R. Diabetologia 2005; 48(7): 1247-1257. http://doi.org/10.1007/s00125-005-1802-7.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. J Clin Endocrinol Metab 2007; 92(6): 2017-2029. http://doi.org/10.1210/jc.2007-0298.

American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults. J Am Geriatr Soc 2014;62(1): 147-152. http://doi.org/10.1111/jgs.12631.

Cosman F, et al. Osteoporos Int 2014; 25(10): 2359-2381. http://doi.org/10.1007/s00198-014-2794-2.

Leslie WD, et al. J Bone Miner Res 2012;27(11): 2231-2237. http://doi.org/10.1002/jbmr.1759.

Anagnostis P, et al. Goulis DG. Endocrine 2018; 60(3): 373-383. http://doi.org/10.1007/s12020-018-1548-x.

Keegan TH, et al. Diabetes Care 2004; 27(7): 1547-1553. http://doi.org/10.2337/diacare.27.7.1547.

Vestergaard P, et al. Calcif Tissue Int 2011; 88(3): 209-214. http://doi.org/10.1007/s00223-010-9450-4.

Inoue D, et al. Calcif Tissue Int 2016; 98(2): 114-122. http://doi.org/10.1007/s00223-015-0071-9.

Ringe JD, et al. Rheumatol Int 2004; 24(2): 110-113. http://doi.org/10.1007/s00296-003-0388-y.

Ringe JD, et al. Rheumatol Int 2 006; 2 6(5): 4 27-431. http://doi.org/10.1007/s00296-005-0004-4.

Ringe JD, et al. Rheumatol Int 2009; 2 9(3): 311-315. http://doi.org/10.1007/s00296-008-0689-2.

Boonen S, et al. J Bone Miner Res 2009; 24(4): 719-725. http://doi.org/10.1359/jbmr.081214.

Boonen S, et al. N Engl J Med 2012; 367(18): 1714-1723. http://doi.org/10.1056/NEJMoa1204061.

Lyles KW, et al. N Engl J Med 2007; 357(18): 1799-1809. http://doi.org/10.1056/NEJMoa074941.

Orwoll ES, et al. J Bone Miner Res 2003; 18(1): 9-17. http://doi.org/10.1359/jbmr.2003.18.1.9.

Orwoll E, et al. J Clin Endocrinol Metab 2012; 97(9): 3161-3169. http://doi.org/10.1210/jc.2012-1569.

Grygorievа N. Efficiency and safety of ibandronic acid: focus on the results of randomized researches and meta-analysеs. PJS. 2019;9(1):36-45. DOI:https://doi.org/10.22141/2224-1507.9.1.2019.163057. (Ukrainian)

Yates J. Osteoporos Int 2 013; 24(1): 253-262. http://doi.org/10.1007/s00198-012-2179-3.

Zhang J, et al. Asian Pac J Trop Med 2 012; 5 (9): 743-748. http://doi.org/10.1016/S1995-7645(12)60118-7.

Crandall CJ, et al. Ann Intern Med 2014; 161(10): 711-723. http://doi.org/10.7326/M14-0317.

Barrionuevo P, et al. J Clin Endocrinol Metab 2019; 104(5): 1623-1630. http://doi.org/10.1210/jc.2019-00192.

Freemantle N, et al. Osteoporos Int 2013; 24(1): 209-217. http://doi.org/10.1007/s00198-012-2068-9.

Paggiosi MA, Peel N, McCloskey E, Walsh JS, Eastell R. Comparison of the effects of three oral bisphosphonate therapies on the peripheral skeleton in postmenopausal osteoporosis: the TRIO study. Osteoporos Int. 2014 Dec; 25(12):2729-41.

Pyon EY. Clin Ther 2 006; 2 8(4): 4 75-490. h ttp://doi.org/10.1016/j.clinthera.2006.04.006.

Reginster JY, et al. Ann Rheum Dis 2006; 65(5): 654-661. http://doi.org/10.1136/ard.2005.044958.

Eisman JA, et al. J Rheumatol 2008; 35(3): 488-497.

Harris ST, et al. Curr Med Res Opin 2008; 24(1): 237-245. http://doi.org/10.1185/030079908x253717.

Silverman SL, et al. Osteoporos Int 2007; 18(1): 25-34. http://doi.org/10.1007/s00198-006-0274-z.




How to Cite

Zhuravlyova, L., Oliinyk, M., & Sikalo, Y. (2021). FEATURES OF MANAGEMENT IN PATIENTS WITH OSTEOPOROSIS AND DIABETES MELLITUS. Problems of Endocrine Pathology, 77(3), 111-119. https://doi.org/10.21856/j-PEP.2021.3.16