We welcome the timely Personal View on bone disease in diabetes by Vikram Shanbhogue and colleagues.¹ We believe that the increased fracture risk in patients with diabetes is caused by multiple factors including insulin deficiency, hyperinsulinaemia, an altered incretin response, obesity, use of glucose-lowering drugs, use of antihypertensive and lipid-lowering drugs, comorbidities, falls, and diabetes complications. We suggest that interplay of these factors causes the increased fracture risk in patients with diabetes and that diabetic bone disease is not predominantly attributable to the presence of microvascular disease.

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解开糖尿病与骨病之间的联系

我们欢迎Vikram Shanbhogue及其同事对糖尿病的骨病及时发表个人观点。¹我们认为，糖尿病患者骨折风险的增加是由多种因素引起的，包括胰岛素缺乏，高胰岛素血症，肠降血糖素反应改变，肥胖，使用降糖药，使用降压和降脂药，合并症，跌倒，和糖尿病并发症。我们建议这些因素的相互作用会导致糖尿病患者骨折风险的增加，并且糖尿病性骨病并非主要归因于微血管疾病的存在。