Figure 1.

Mechanisms of bone metabolic disorder induced by diabetes. Diabetes leads to hyperglycemia because of a lack of insulin or insulin resistance; increases inflammation; and results in the generation of advanced glycation end-products and reactive oxygen species. This dysregulation and an increase in the RANKL/OPG ratio may lead to greater osteoclast production, thereby promoting bone resorption. Diabetes is associated with hyperglycemia, inflammation, and the generation of AGEs and ROS. This may lead to a reduction in the expression of BMPs and Runx2, and an increase in the expression of PPARγ and/or other mechanisms that reduce bone formation.