Chronic Systemic Inflammation and Insulin Resistance: A Synergistic Pathway in the Development of Secondary Osteoporosis

There is a strong causal link between chronic diabetes, inflammation, and secondary osteoporosis; this link is also often discussed as the diabetic bone disease development process. In this process, where systemic chronic inflammation and insulin resistance (IR) are key contributing factors, diabetes directly disrupts bone remodelling, leading to bone weakness and an increased risk of fractures. Moreover, as IR and low-grade inflammation are also associated with both obesity and metabolic syndrome, diabetes and diabetic bone disease are attracting attention due to their increasing prevalence with age in both sexes, particularly in postmenopausal women. This brief review, highlighting the role of chronic systemic inflammation, IR, and metabolic interactions in the relationship between Type 2 diabetes and secondary osteoporosis, focuses on summarising current developments to provide references for clinical practice in light of recent research data and current literature. Furthermore, increased knowledge regarding diagnostic approaches can contribute to reducing the occurrence of frailty fractures in diabetes through early diagnosis and interventions.