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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 5/2013

01.07.2013 | Beiträge zum Themenschwerpunkt

Diabetes und Osteoporose

Pathophysiologische Interaktionen und klinische Bedeutung für geriatrische Patienten

verfasst von: MD M. Lechleitner, K. Pils, R. Roller-Wirnsberger, E. Beubler, R. Gasser, P. Mrak, F. Hoppichler, P. Pietschmann

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 5/2013

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Zusammenfassung

Die Osteoporose ist eine altersassoziierte Erkrankung, die zu einer verminderten Knochenfestigkeit und einem erhöhten Frakturrisiko führt. Patienten mit einem Typ-2-Diabetes mellitus zeigen trotz einer normalen oder sogar gesteigerten Knochendichte ein erhöhtes Frakturrisiko, das auf ein Missverhältnis zwischen der osteoblastären Knochenneubildung und dem Knochenabbau durch Osteoklasten zurückgeführt wird. Komplexe pathophysiologische Mechanismen in Folge der Insulinresistenz und der Hyperglykämie liegen diesen Veränderungen zugrunde. Diskutiert wird auch ein möglicher Einfluss der Qualität und Form der antidiabetischen Therapie auf das Frakturrisiko. Für die klinische Praxis von Bedeutung ist die Beurteilung des Sturzrisikos, das bei Patienten mit Diabetes aufgrund diabetischer Spätkomplikationen, wie der Neuropathie, aber auch infolge von Nebenwirkungen der medikamentösen Therapie gegenüber einer nichtdiabetischen Vergleichspopulation erhöht ist. Lebensstilmaßnahmen stellen die Basisintervention in der Prävention und Therapie des Diabetes mellitus wie auch der Osteoporose dar. Die Supplementierung mit Vitamin D zeigt neben den präventiven Effekten auf das Sturz- und Frakturrisiko eine günstige Einflussnahme auf die Insulinsensitivität. Die Effektivität und Sicherheit spezifischer Formen der Osteoporosetherapie (Bisphosphonate, Denosumab, selektive Östrogenrezeptormodulatoren) zeigt entsprechend der vorliegenden Daten aus der Literatur keinen Unterschied zwischen Patienten mit und ohne Diabetes mellitus.
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Metadaten
Titel
Diabetes und Osteoporose
Pathophysiologische Interaktionen und klinische Bedeutung für geriatrische Patienten
verfasst von
MD M. Lechleitner
K. Pils
R. Roller-Wirnsberger
E. Beubler
R. Gasser
P. Mrak
F. Hoppichler
P. Pietschmann
Publikationsdatum
01.07.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 5/2013
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-013-0518-4

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