Differentiation of pluripotent mesenchymal stem cells is one of the key-factors in diabetic bone metabolism. Key role is played by Peroxisome-Proliferator-activated Receptor (PPAR-gamma).
Some of antidiabetic drugs, mostly represented by thiazolidinodiones (rosiglitazone) could negatively influence bone metabolisms in diabetic patients. The other factors are represented by changes in IGF-I, renal failure, chronic inflammation and disturbed immunocompetence