Fracture risk in young and middle-aged adults with Type 1 diabetes mellitus: a systematic review and meta-analysis

Helena Teede et al. published in Clinical Endocrinology.

Increased prevalence of fracture and hypoglycaemia in young adults with concomitant type 1 diabetes mellitus and coeliac disease

Fran Milat et al. published in Clinical Endocrinology.

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Minimal-trauma ankle fractures predominate during pregnancy: a 17-year retrospective study

Fran Milat et al. published in Archives of Osteoporosis.

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Urolithiasis is prevalent and associated with reduced bone mineral density in β-thalassaemia major

Kenneth Lau et al. published in the Internal Medicine Journal.

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Hip fractures in young adults: a retrospective cross-sectional study of characteristics, injury mechanism, risk factors, complications and follow-up

Michael Wang et al. published in Archives of Osteoporosis.

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Serum phosphorus levels and fracture following renal transplantation

Jasna Aleksova et al. published in Clinical Endocrinology.

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A new contralateral atypical femoral fracture despite sequential therapy with teriparatide and strontium ranelate

Hanh Nguyen et al. published in Bone Reports.

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Optimizing bone health in cerebral palsy across the lifespan

Anne Trinh et al. published in Developmental Medicine and Child Neurology.

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GPs need to become champions for osteoporosis treatment

Professor Peter Ebeling

OSTEOPOROSIS treatment represents a missed opportunity for medical practitioners, according to the authors of a narrative review published in yesterday’s Medical Journal of Australia.

Only a small percentage of patients presenting to the health care system with minimal trauma fractures are being investigated or treated for osteoporosis, despite it affecting 1.2 million Australians.

Associate Professor Frances Milat and Professor Peter Ebeling from Monash University and Monash Health wrote that “there is a major gap between evidence and treatment in secondary fracture prevention, with fewer than 20% of patients presenting with a minimal trauma fracture being treated or investigated for osteoporosis”.

Associate Professor Fran Milat

Osteoporosis treatment is recommended in patients with a high absolute fracture risk.

“This includes older Australians (post-menopausal women and men aged over 60 years) with T scores £ -2.5 at the lumbar spine, femoral neck or total hip, and patients with a history of a minimal trauma fracture,” the authors wrote.

There are a growing number of effective therapies for osteoporosis for which the benefits far outweigh the risks.

Two are antiresorptive drugs, which decrease the number, activity and lifespan of osteoclasts, and teriparatide, which stimulates osteoblast recruitment and activity. There are also newer anti-osteoporosis drugs in clinical development.

In addition, non-pharmacological therapies such as calcium and vitamin D, exercise and fall reduction strategies can help prevent osteoporosis.

The authors wrote that the time to close the gap between evidence and treatment is well overdue.

They concluded: “General practitioners also need to take up the challenge imposed by osteoporosis and become the champions of change, working with the support of specialists and government to reduce the burden of fractures caused by osteoporosis in Australia.”

Bone Disease in Thalassemia: A Molecular and Clinical Overview.

Fran Milat et al. published in Endocrine Reviews.

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