摘要
第二型糖尿病是盛行率很高的代謝系統疾病，會造成各組織器官功能異常，甚至增加罹病率和死亡率。近年來越來越多文獻報告糖尿病患者體內多重複雜因素可能造成骨骼代謝異常，增加骨折發生率及後續併發症。骨折發生率與骨密度有高度相關，研究顯示第二型糖尿病患者的脊椎骨和髖部骨密度比無糖尿者略高，骨折發生率也顯著較高。第二型糖尿病患者骨折風險增高的推測原因很多，但實際機轉並不清楚。許多骨骼相關的內在或外在因子，如血糖調控異常、控制糖尿病使用之藥物、骨骼相關激素、維生素D及糖尿病後期併發症，以及跌倒都可能增加骨折發生率。因此糖尿病患者的照護除傳統心血管系統併發症之外，骨骼健康也是未來應注重的一環。除檢測骨密度外，針對第二型糖尿病患者的骨折風險評估，可透過過去病史、藥物使用、身體檢查，以及實驗室血液檢驗，協助醫療人員全面評估骨折的潛在危險因子。物理治療介入則應著重防跌策略，並強化第二型糖尿病患者的肌肉力量、平衡能力及居家無障礙環境改良的預防性介入措施。
並列摘要
Type 2 diabetes mellitus is a high-prevalent metabolic disease which causes systemic dysfunction and increases morbidity and mortality. In recent years, more and more literatures have reported that individuals with type 2 diabetes have increased fracture risk despite higher bone mineral density (BMD). The multiple and complex factors associated with diabetes mellitus may contribute to abnormal bone metabolism as well as increased incidence of fractures and subsequent complications, such as abnormal blood sugar regulation, antidiabetic agents use, bone-related hormones, vitamin D deficiency, end-stage complications of diabetes, and falls. Therefore, bone health care for diabetic patients should be an important issue in addition to its traditional cardiovascular complications in the future. The comprehensive assessment of potential risk factors for fracture in type 2 diabetes mellitus should include not only BMD but also the past medical history, drug use, physical examination, and laboratory blood tests. Physical therapy intervention could emphasize on muscle strengthening, balance training, and the barrier-free home environment modification to improve BMD and prevent falls for patients with type 2 diabetes.
延伸閱讀
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- 游雪峰（2007）。照顧好您的骨本－糖尿病病患是骨質流失及骨折的高危險群。人醫心傳－慈濟醫療人文月刊，(44)，70-72。https://doi.org/10.30151/MH.200708.0015
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