Análise dos fatores de risco para o desenvolvimento de fragilidade óssea em pacientes portadores de diabetes mellitus tipo 2 atendidos no Centro de Especialidades Médicas do CESUPA

Abstract

INTRODUCTION: Diabetes mellitus (DM) is a chronic metabolic disease with high worldwide prevalence. Type 2 diabetes patients are at risk of developing several complications, with bone fragility being the most recently reported. Osteoporosis is characterized by low bone mass, which predisposes to fragility fractures, being the gold standard method for its diagnosis the bone densitometry exam. The influence of diabetes on bone has multifactorial etiology, requiring further studies to make this relationship more consistent. OBJECTIVES: To analyze the presence of risk factors associated with the development of bone fragility and osteoporosis in type 2 diabetic patients treated at the “Centro de Especialidades Médicas do CESUPA” (CEMEC), and also generate an educational product with the purpose of guidance and health promotion, for use in the specialty medical clinics. METHODOLOGY: A cross- sectional, observational and analytical-descriptive study was carried out, based on an interview with the application of a specific questionnaire to patients treated at the “Centro de Especialidades Médicas do Cesupa” (CEMEC), and also an analysis of laboratorial and image exams that were contained in the medical records. RESULTS: A sample of 80 patients was used, being 72,5% female and aged between 51-70 years (58,8%). Most (52,5%) had been diagnosed with diabetes for more than 10 years, 70% had fasting glucose <150mg/dL and 77,5% had glycated hemoglobin levels below 8,5%. Among the 80 patients surveyed, 48,8% referred to be a former smoker in the past and 16,3% reported chronic use of corticosteroids. Most (66,3%) related using antidiabetic drugs with an impact on bone metabolism, 8,8% reported previous fragility bone fractures and 26,4% of the fifty-three patients with target-organ lesions had diabetic neuropathy. Those who underwent bone densitometry corresponded to 42,5%, of whom 28,8% received the densitometric diagnosis of osteoporosis. Most (46,3%) individuals had an average fracture risk calculated by FRAX®. CONCLUSION: There was a significant association between previous fragility fracture, smoking and chronic use of corticosteroids with increased risk of fracture. Bone fragility should be considered a complication of diabetes, and the design of prevention and screening strategies is essential, in addition to spreading information to patients about their disease and ways to improve its control.