In the U.S., 2 million older adults experience a fracture annually with treatment costs of $17 billion. Those with type 1 or type 2 diabetes have an increased fracture risk. Thus, the morbidity from fractures, already identified as an important public health issue in the broader population of older adults, is even more prevalent among those with diabetes. The quality of diabetic bone is compromised but the reasons for this are not understood, impeding the ability to diagnose and treat osteoporosis in diabetic patients. Current clinical tools under- estimate fracture risk in diabetic patients, and the goal of improving risk assessment has spurred investigations into biochemical markers, microstructure and material properties of diabetic bone. There is increasing awareness that diabetes medications may have skeletal effects. This is a crucial juncture and opportunity for research into the effects of disordered energy metabolism on bone. Advances are being made in the clinical and basic biology arenas. However, progress is hampered by the lack of venues for communication across bone and energy metabolism research and by separations among investigators in basic science, epidemiology, and translational and clinical medicine. This symposium will provide a venue for interaction at the meeting itself and through dissemination of post-meeting summaries, reaching well beyond those in attendance and bringing a new level of maturity to this research.
The specific aims are 1) To present the latest research on the effects of disordered energy metabolism and diabetes on bone biology, including effects on bone cells, material properties and microstructure, 2) To present the latest research on the diagnosis and management of osteoporosis in patients with diabetes and on the potential skeletal effects of diabetes treatments and 3) To promote interaction among basic, translational and clinical researchers in osteoporosis and diabetes research. The symposium will provide opportunities for interactions and collaborations at the poster sessions, during lunch and through a dine-around for young and senior investigators.
The aims will be accomplished by inviting internationally known researchers to present their latest data on advances in understanding insulin resistance, lessons from preclinical models of diabetes and bone, human bone metabolism in diabetes, the effects of diabetic medications on bone, the limitations of FRAX in diabetic patients and diabetes-related risk factors for fracture, and pharmacological therapies for osteoporosis in diabetic patients. The symposium will conclude with a panel of clinical experts addressing """"""""Clinical management: what is known and where is more research needed?"""""""" Attendees will be encouraged to attend the ASBMR 2014 Annual Meeting following the symposium and vice versa. Support will be provided to encourage young investigators to attend. The symposium will generate a better understanding of diabetes and bone, bridge the gaps among investigators in the basic science, translational and clinical arenas, increase communication and interaction among investigators in bone and in energy metabolism, and provide significant maturation for this crucial area of research.

Public Health Relevance

Diabetic bone is more fragile, leading to a higher risk of fractures in those with type 1 or type 2 diabetes, but the reasons for reduced bone quality are not understood. More research is being devoted to understanding diabetic bone but progress is hampered by a lack of communication between the fields of bone and energy metabolism and across traditionally separate areas of basic and clinical research. This one-day symposium will present the latest research on the effects of diabetes and energy metabolism on bone, provide a venue for investigators to interact across traditional barriers, and promote a new level of maturity for this rapidly expanding interdisciplinary research.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Conference (R13)
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Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Sharrock, William J
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American Society for Bone & Mineral Research
United States
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