An update on bone in diabetes

PURPOSE OF REVIEW: As the prevalence of diabetes mellitus (DM) increases due to urbanization, aging populations, and lifestyle changes, it is crucial to understand the mechanisms, diagnosis, and treatment of diabetes-related bone disorders. This review highlights recent advancements in the field and explores their implications for clinical practice and research. RECENT FINDINGS: Recent studies have elucidated the complex interplay between diabetes and bone health, emphasizing the roles of advanced glycation end-products (AGEs), inflammation, oxidative stress, senescence, and molecular signaling pathways such as Wnt, mammalian target of rapamycin (mTOR), and exosome-mediated mechanisms. Key findings highlight the significance of bone marrow adipose tissue (BMAT) in bone metabolism and the impact of sarcopenia on fracture risk. Novel diagnostic tools, including miRNA biomarkers and emerging therapeutic strategies like exosome-based therapies and glycogen synthase kinase 3 beta (GSK3β) inhibitors, offer promising opportunities for improving bone health in diabetic patients. SUMMARY: The findings underscore the need for integrated strategies for managing diabetes-related bone complications. Clinicians should prioritize early screening, lifestyle interventions, and personalized pharmacological treatments to mitigate fracture risk and improve bone health in diabetic patients. Future research should focus on optimizing diagnostic tools and developing targeted therapies to address the unique challenges of bone disorders related to diabetes.