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Diabetes and osteoporosis - the sweet and the sour

Diabetes and osteoporosis - the sweet and the sour
  • Endocrinology and metabolism


26 February 2014

Course introduction


This online course, prepared by Sol Epstein, looks at the link between diabetes and osteoporosis.

The course describes the burden of diabetes and osteoporosis, particularly fractures, and the consequences of such burdens that will occur over the next twenty years, especially in the emergent economies of Asia, Africa and South America.

The different effects of type I and type II diabetes on bone density, bone quality and fracture are discussed. Methods of bone imaging to assess density and quality are reviewed. Treatment options, albeit not established, are considered.

Learning objectives

By the end of this course, participants should be able to:

  • Describe the risk to diabetic patients of bone disease
  • Understand the various contributing factors to the bone abnormalities described
  • Understand the effects of diabetes on bone density and bone quality
  • Appreciate the consequences of these bone alterations on fracture incidence
  • Understand that, despite the lack of evidence-based therapies, this disease needs to be recognised and treated

Target audience

Endocrinologists/Diabetologists and other healthcare professionals treating diabetes.

Instructions for participation

There are no fees for participating in this online activity.

This online course is expected to take approximately 60 minutes for completion.

As you progress through the course material there are several short true/false and multiple-choice questions. The answers to the questions are provided in the following slides or video. These questions are not part of the course assessment but provide focus for you to reflect on the material covered in the previous section.

Once you have completed the activity, you should undertake the final assessment test comprising 12 questions. If you achieve a score of 80% or greater you will be able to download a certificate.


All EXCEMED programmes are organized solely to promote the exchange and dissemination of scientific and medical information. No forms of promotional activities are permitted. There may be presentations discussing investigational uses of various products. These views are the responsibility of the named speakers, and do not represent an endorsement or recommendation on the part of EXCEMED. This programme is made possible thanks to an educational grant received from Merck.


Sol Epstein, MD, FRCP, FACP

Professor of Medicine and Geriatrics, Mt Sinai School of Medicine New York, New York, USA
Adjunct Professor of Medicine, University of Pennsylvania, Pennsylvania, USA


Sol Epstein is Professor of Medicine and Geriatrics at Mt. Sinai University School of Medicine in New York, USA. Dr Epstein has focused his career on bone and mineral teaching and research. He has established many academic scientific initiatives in this area and has conducted basic research and clinical trials in osteoporosis.  He has received research grants from the NIH and other extra-mural sources.

Dr Epstein has authored over 250 peer-reviewed publications and many book chapters. He sits on a number of editorial boards, is co-editor of the Oxford short textbook of endocrinology, and guest editor for Reviews in Endocrinology and metabolism.

Dr Epstein has served worldwide as a Visiting Professor of Medicine in countries including the United Kingdom, Latin America, Asia, Australia, the Middle East and southern Africa. He was co-organiser of the first international meeting on secondary causes of osteoporosis in 2006 (Florence, Italy).

Faculty disclosure

Disclosure of faculty relationships

EXCEMED adheres to guidelines of the European Accreditation Council for Continuing Medical Education (EACCME) and all other professional organizations, as applicable, which state that programs awarding continuing education credits must be balanced, independent, objective, and scientifically rigorous. Investigative and other uses for pharmaceutical agents, medical devices, and other products (other than those uses indicated in approved product labeling/package insert for the product) may be presented in the program (which may reflect clinical experience, the professional literature or other clinical sources known to the presenter). We ask all presenters to provide participants with information about relationships with pharmaceutical or medical equipment companies that may have relevance to their lectures. This policy is not intended to exclude faculty who have relationships with such companies; it is only intended to inform participants of any potential conflicts so participants may form their own judgments, based on full disclosure of the facts. Further, all opinions and recommendations presented during the program and all program-related materials neither imply an endorsement, nor a recommendation, on the part of EXCEMED. All presentations solely represent the independent views of the presenters/authors. The following faculty provided information regarding significant commercial relationships and/or discussions of investigational or non-EMEA/FDA approved (off-label) uses of drugs.

Sol Epstein has received grants and contracts form Merck and received honoraria and consulting fees from Merck and Takeda pharmaceutical companies. He is a member of an advisory board for Merck. He has participated in company-sponsored speaker’s bureaus for Merck and Takeda. Dr Epstein’s presentation includes discussion of off-label (non-approved) uses of medicinal products.