“He might come in useful.’ ‘Yeah. So’s a broken leg if you want to kick yourself in the back of the head.”

So, already one session in, and I’ve already made a mistake. I had to choose between IGF Tumor Microenvironment: Bench to Bedside, and Diabetes And The Skeleton. Since I was stuffing a sugary, sweet donut in my face I figured I’d skip the Diabetes for now, and head to the Insulin-Like Growth Factor one.

Unfortunately for me, Dr Teresa Wood’s talk focussed on Wnt signalling and breast cancer; areas I’m not to hot on. I know the point of conferences is to learn new things, but it was too much for me that early in the morning.

And obviously I had sugar and caffeine coursing through my veins so I went for a wander. Only like 4 minutes, but I ended up at the Diabetes And The Skeleton talks in time for Dr Joshua Farr’s talk about Bone Quality in Diabetes, and I have to say it was great.

Well the bone quality isn’t. Those with Diabetes have increased rate of fractures, but somewhat surprisingly increased fractures correlates with increased bone density. This increased bone density is linked to an increased BMI, due to the workload involved in carrying out all the weight.

However, the quality of the bone (from the title yeah?) is worse. The surface of the bone is more porous in T2D subjects, and the pores are larger and deeper. New technology, namely OsteoProbe, allows bones to be studied less invasively. A small incision is made, after local anaesthetic, and bone strength can be measured. Not surprisingly (since I keep saying it) bone strength is lower in T2D

This low bone strength correlates strongly with poor glycaemic control. Hyperglycaemia leads to advanced glycoslyation endoproducts (AGEs) affect osteoblasts and prevent the formation of new bone. Furthermore, AGEs can inhibit the turnover, meaning that not only is no new bone made, old bone is not repaired. Leading to bad, bad, terrible bone.

I also stuck about for the puntastic Drugs for Diabetes: Bad to the Bone? by Dr Christian Meier. He finished with the best ways to prevent bone loss in T2D.

1. Normoglycaemia

2. Encourage exercise

3. Prevent and treat any complications, which can affect bone strength and density

4. Use metformin and incretins over TZDs. TZDs are the drugs referenced in the title, and have been shown to decrease bone mass. But fortunately, this can be rescued by switching to metformin.

Overall, it looks like more research is needed on the role of T2D, and the associated medications, on bones.

Today’s quote (quotes?) is (are?) from Iain M. Banks

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