@article{ref1,
title="Why do falls and lower limb fractures occur more frequently in the diabetic patient and how can they be prevented?",
journal="Diabetes therapy",
year="2020",
author="Bell, David S. H. and Goncalves, Edison",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Due to primarily sarcopenia and hypoglycemia but also neuropathy, hypotension, analgesics and polypharmacy, there is an increased incidence of falls and hip fractures in both the type 1 and type 2 diabetic patient. Utilization of insulin, hypotensive drugs, analgesics and perhaps canagliflozin further increases the risk. Thiazolidinedione use may increase the risk of osteoporosis and fracture. Prolonged hyperglycemia resulting in cross-linking of collagen and advanced glycosylation end products alter the microarchitecture and increase bone fragility. Higher serum vitamin D levels seem to decrease the incidence of both falls and fractures. Following a hip fracture, mortality in the diabetic patient is increased largely because of cardiovascular events and pneumonia. Prevention of sarcopenia includes dietary therapy, vitamin D and testosterone replacement when appropriate.<p /> <p>Language: en</p>",
language="en",
issn="1869-6953",
doi="10.1007/s13300-020-00877-z",
url="http://dx.doi.org/10.1007/s13300-020-00877-z"
}