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Diabetes aktuell 2021; 19(04): 178-183
DOI: 10.1055/a-1508-3113
Schwerpunkt

Osteoporose bei Diabetes mellitus

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Elena Tsourdi
1   UniversitätsCentrum für Gesundes Altern & Bereich Endokrinologie/Diabetes/Knochen erkrankungen, Medizinische Klinik und Poliklinik III, Technische Universität Dresden
,
Lorenz C. Hofbauer
1   UniversitätsCentrum für Gesundes Altern & Bereich Endokrinologie/Diabetes/Knochen erkrankungen, Medizinische Klinik und Poliklinik III, Technische Universität Dresden
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ZUSAMMENFASSUNG

Aufgrund ihrer hohen und mit zunehmendem Alter steigenden Prävalenz in der Allgemeinbevölkerung sind Osteoporose und Diabetes mellitus globale Gesundheitsprobleme. Osteoporose kann sowohl mit antiresorptiven, als auch osteoanabolen Medikamenten erfolgreich behandelt werden. Während diese Medikamente bei Patientinnen mit postmenopausaler und Patienten mit männlicher Osteo porose eindeutig das Frakturrisiko senken, ist noch unklar, ob sie bei Menschen mit diabetischer Knochenerkrankung die gleiche Wirksamkeit haben. Darüber hinaus sind aus dem Knochen stammende Zytokine (Osteokine) in der Lage, den Glukosestoffwechsel zu beeinflussen. Es ist denkbar, dass Medikamente gegen Osteoporose durch ihre Modulation des Knochen umsatzes und insbesondere der Osteokine den Blutzuckermetabolismus beeinflussen können. Die Modulation des Knochenumsatzes durch Osteoporosemedikamente scheint für den Glukosestoff- wechsel des Menschen jedoch keine klinisch bedeutsame Rolle zu spielen. Substanzen aus der Gruppe der Bisphosphonate sind Medikamente der 1. Wahl für die Behandlung der Osteoporose bei diabetischen Patient/-innen, während Denosumab für ältere Pa tient/-innen, insbesondere bei eingeschränkter Nierenfunktion, geeignet ist. Osteoanabole Substanzen wiederum kommen vorrangig bei Menschen mit schweren Formen von Osteoporose zum Einsatz.



Publication History

Article published online:
25 June 2021

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