The increased bone fracture risk associated with osteoporosis is well studied. Type 2 Diabetes Meillitus (T2DM) is also associated with an increased fracture risk, the mechanisms of which are not well understood or researched especially in humans. T2DM is a disease affecting an increasing proportion of the population. It not only raises fracture risk by reducing bone quality, but impairs proper bone formation, thus hindering normal fracture healing. This makes the mechanisms affecting diabetic bone quality a worthy research topic.
A recently completed study managed by project sponsor (Dr. Parle) examining microstructure, mineral content and mechanical properties of human femoral heads was unable to unearth possible causes of the increased fracture risk in T2DM compared to osteoarthritic (control) hips at the levels examined. The same study highlighted significant differences in every variable analysed between osteoporotic and osteoarthritic patients, implying T2DM effects the bone differently to osteoporosis. In the biomedical engineering department (NUI, Galway), we have a unique opportunity in the form of a collaboration with local orthopaedic surgeons, who provide us with femoral heads from diabetic, osteoporotic and osteoarthritic patients undergoing total hip replacement surgery. Previous research has revealed the presence of abnormal collagen cross-linking in diabetic bone. We believe that a comprehensive analysis of the collagen cross linking present in these patient groups, together with an analysis of the toughness of the bone samples may shed light on the reasons for increased fracture risk in diabetes, possibly highlighting methods for diagnosis and treatment of diabetic induced bone quality reduction.
