Figure2.

Mechanisms of diabetes-reduced bone formation. Diabetes leads to hyperglycemia, enhanced and prolonged inflammation, formation of AGEs and generation of ROS. This dysregulation as well as reduced insulin signaling may adversely affect osteoblasts and reduce bone formation particularly when bone is challenged by wounding, bacteria induced inflammation or other events that disrupt homeostasis. The effect of dysregulation may lead to a reduction in BMPs, Runx2 or Fra1, an increase in PPARγ or other mechanisms to reduce bone formation or bone quality.