| Insulin resistance is one of the important pathogenic mechanisms of type 2 diabetes. As the degree of insulin resistance increases, changes in bone growth and bone remodeling process lead to an increased risk of fractures. In patients with insulin resistance, osteoporosis that does not completely manifest as decreased bone density, may also manifest as normal or high bone density, resulting in no obvious abnormalities in bone mineral density and an increased risk of fracture in patients with type 2 diabetes. This may be due to reduced osteoblast and osteoclast sensitivity to insulin or low inflammation caused by insulin resistance, decreased vitamin D, mineralization of osteocyte spaces, and other factors affecting bone formation and bone resorption. The mechanism by which insulin resistance leads to bone strength loss needs to be fully elucidated in order to guide anti-osteoporosis therapy in patients with insulin resistance. |