Meeting Summary—ASBMR Symposium: The Effects of Diabetes and Disordered Energy Metabolism on Skeletal Health
Fractures are a costly public health burden at the societal and individual level. In 2005 approximately 2 million fractures occurred in the U.S. among those >50 years old with an estimated treatment cost of $17 billion, projected to increase 50% by 2025. Fractures are a primary concern among adults aged 65 years or older, in whom the prevalence of T2DM mellitus (T2DM) is now greater than 25% in the U.S. Additionally, life expectancy has increased for patients with T1DM and many are living to an age when fracture risk becomes a concern.
Older adults with T2DM are on average overweight and have higher bone density than healthy peers. However, the higher bone mass does not confer protection against fractures. Indeed, the risk of hip fracture is increased by 40-70% in these individuals, and it is 6-fold higher in patients with T1DM, relative to individuals without diabetes; much higher than would be expected from their relatively modest reductions in bone density, pointing towards alterations of bone quality . Of note, fracture incidence is still increased after correcting for falls. Thus, morbidity from fractures, itself an important public health issue in the broader population of older adults, is more prevalent among those with diabetes who are also more likely to have difficulties with fracture healing and rehabilitation than non-diabetic subjects.
The clinical and basic science research community is increasingly interested in understanding the effects of diabetes and impaired energy metabolism on the skeleton. The ASBMR Symposium was designed to provide an opportunity for researchers to share insights and new findings across the barriers that often separate investigators involved with basic, translational and clinical research. The Symposium also aimed to catalyze inter-disciplinary interactions between researchers and clinicians interested in diabetes and those focused on bone health.