Bone in patients with diabetes breaks easily and heals poorly. Sometimes, it does not heal at all. For the patients, this means immobility over months and as a consequence less life quality. Type 2 diabetes mellitus and osteoporosis may affect half of the aging European population. However, the ‘sweet bone phenomenon’ remains a conundrum, since bone mineral density is paradoxically high or normal. Therefore, we set out to answer the fundamental question “How is bone weakened by diabetes?”
We believe that bone material strength is affected by direct and indirect effects of type 2 diabetes mellitus on bone. In the last four years, our group has found that bone microarchitecture and accumulation of advanced glycosation endproducts (AGE) contribute to poor bone quality in diabetes. In our ongoing studies, we test how microvascular damage and persistent low-grade inflammation may contribute to impaired bone cell function. To tackle these research questions, we use preclinical models and comprehensively assess intact and regenerating bone with a spectrum of high-resolution imaging modalities and advanced cell biology methods.
We expect to uncover the cause of poor bone quality in diabetes by focussing on vascular and inflammatory mechanisms and to deliver better bone therapies for patients with diabetes.