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A osteoporose no doente diabético
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A Diabetes Mellitus (DM) é uma doença metabólica crónica cuja prevalência tem vindo a aumentar nos últimos anos. Esta patologia origina inúmeras complicações como nefropatia, neuropatia, hipertensão, entre outras, causadas por níveis de glucose elevados (hiperglicemia) e por alterações no metabolismo dos nutrientes ingeridos. Apesar de a osteoporose (OP) não estar expressa na literatura como uma das complicações da DM, sabe-se, no entanto, que esta constitui um fator de risco para o desenvolvimento da osteoporose.
A osteoporose é caraterizada pela redução crónica da massa e qualidade óssea, o que torna este tecido mais frágil e suscetível a fraturas. Consequentemente acarreta custos a nível mundial na ordem dos 37 biliões de euros, principalmente associados ao tratamento dispendioso das comorbilidades.
Os atuais métodos de diagnósticos da OP não têm em consideração a diabetes como fator de risco. Contudo vários estudos comprovam que tanto a massa óssea na DM tipo 1, como a qualidade óssea na DM tipo 2, estão alteradas, com o consequente aumento da predisposição para o aparecimento de osteoporose.
Diversos mecanismos fisiológicos que se encontram alterados no doente diabético podem explicar o aparecimento de complicações ósseas. Do trabalho de campo efetuado, concluiu-se que existem diferenças estatisticamente significativas quando é utilizada a DMO para o cálculo dos valores de FRAX e que apenas uma pequena percentagem de doentes diabéticos fazem suplementação de cálcio.
Posto isto, torna-se vital reforçar a importância da informação e da educação dos doentes diabéticos pelos profissionais de saúde, de modo a prevenir o surgimento da OP e das suas complicações.
Diabetes Mellitus (DM) is a chronic metabolic disease and its prevalence has been increasing in recent years. This pathology leads to numerous complications such as nephropathy, neuropathy, hypertension, among others, caused by elevated glucose levels (hyperglycemia) and altered metabolism of ingested nutrients. Although osteoporosis (OP) is not expressed in the literature as one of the complications of DM, it is known that it constitutes a risk factor for the development of osteoporosis. Osteoporosis is characterized by chronic reduction of the bone mass and its quality, which makes the tissue more fragile and susceptible to fractures. Consequently, it entails worldwide costs around 37 billion euros per year, mainly associated with costly treatment of comorbidities. The current methods of diagnosing OP do not consider diabetes as the risk factor. However, several studies have shown that both the bone mass in type 1 DM, and bone quality in type 2 DM are altered, with a consequent increase in the predisposition to the onset of osteoporosis. Several physiological mechanisms that are altered in the diabetic patient may explain the appearance of bone complications. The field work carried out concluded that there are statistically significant differences when BMD is used to calculate FRAX values and that a small percentage of diabetic patients are supplementing calcium. Having said this, it is vital to reinforce the importance of information and education of diabetic patients by health professionals, to prevent the occurrence of OP and its complications.
Diabetes Mellitus (DM) is a chronic metabolic disease and its prevalence has been increasing in recent years. This pathology leads to numerous complications such as nephropathy, neuropathy, hypertension, among others, caused by elevated glucose levels (hyperglycemia) and altered metabolism of ingested nutrients. Although osteoporosis (OP) is not expressed in the literature as one of the complications of DM, it is known that it constitutes a risk factor for the development of osteoporosis. Osteoporosis is characterized by chronic reduction of the bone mass and its quality, which makes the tissue more fragile and susceptible to fractures. Consequently, it entails worldwide costs around 37 billion euros per year, mainly associated with costly treatment of comorbidities. The current methods of diagnosing OP do not consider diabetes as the risk factor. However, several studies have shown that both the bone mass in type 1 DM, and bone quality in type 2 DM are altered, with a consequent increase in the predisposition to the onset of osteoporosis. Several physiological mechanisms that are altered in the diabetic patient may explain the appearance of bone complications. The field work carried out concluded that there are statistically significant differences when BMD is used to calculate FRAX values and that a small percentage of diabetic patients are supplementing calcium. Having said this, it is vital to reinforce the importance of information and education of diabetic patients by health professionals, to prevent the occurrence of OP and its complications.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2017
Palavras-chave
Diabetes Mellitus Osteoporose Ferramenta de Avaliação do Risco de Fratura Fraturas e Densidade Mineral Óssea Mestrado Integrado - 2017