The Osteoporosis Program at Diabetes and Metabolism

(where else?)



Osteoporosis Facts:-



Twenty-four million Americans have osteoporosis


Osteoporosis is responsible for 1.3 million fractures a year


One-third to one-half of all post-menopausal women are affected by osteoporosis


Premature menopause, excessive exercise, or anorexia may cause osteoporosis in women as early as the mid-thirties


The incidence of osteoporosis is expected to double by the year 2020 as the population ages


$$the annual cost of treating osteoporosis is $10 billion$$



Osteoporosis is often called "the silent disease" because patients do not usually present with symptoms until the disease is advanced and fracture occurs. After bone mass peaks in the mid-thirties, calcium loss occurs gradually then accelerating in the menopause. Women with osteoporosis have experienced an exaggerated accleration of bone loss. Since bone health is influenced by diet, exercise, estrogen availability, and other risk factors - patients can benefit from controlling such modifiable risk factors as: use of steroids, excess thyroid medications, anticonvulsants, eating disorders, diet low in calcium, smoking and excess use of alcohol. Early detection of osteoporosis is vital. If left undetected osteoporosis may lead to irreversible damage to bone structure. A loss of height, spontaneous fractures, and debilitating pain may result. Loss of height usually occurs in bursts of one inch or more, and a woman may lose six inches or more from her adult height. The most effective way to deal with osteoporosis is to focus on preserving bone mass, therefore postmenopausal women should be encouraged to seek bone density testing bone fractures occur.

Diagnosis - Bone Densitometry Bone density measurements are an invaluable aid in diagnosing osteoporosis and other metabolic diseases. Here at TOPaDaM (tm), patients will undergo bone density testing with the state-of-the-art dual energy (DEXA) bone densitometer - the Norland Eclipse (tm). This advanced technology ensures precise, reliable and speedy scans - about five minutes per site tested. Bone densitometry is both painless and safe. Emitted through a tightly focused or "collimated" beam of radiation, the dose is so miniscule that lead lining of the room or shielding of the technician is unnecessary. Bone densitometry is the single most reliable method to: (1) detect low bone mass assess the rate of bone loss and the risk of future fractures (2) confirm a diagnosis of osteoporosis (3) help distinguish spinal osteoporosis from other spinal abnormalities (4) monitor the effect of treatment

Indications - Bone densitometry is as accurate as it is fast. Patient results include a computerized image of the tested area, bone mineral density measurements, and comparisons with "age matched" and "young normal" standards. Age-matched readings compare bone density to what is expected in someone of the patient's age and size. The young normal readings compare the patient's bone density to the estimated peak bone density of a healthy young adult of the same sex.Indications include: (1) evaluation of both perimenopausal and menopausal women (2) patients with xray evidence of vertebral osteopenia or osteoporosis (3) patients receiving long term corticosteroid therapy (4) patients with asymptomatic primary\par hyperparathyroidism (5) patients with other metabolic diseases that adversely affect the skeleton or result in secondary osteoporosis (6) patients with a previous history of hip and/or wrist and/or spinal fracture


Service and Referral Options

Your patient may be referred to the Osteroporosis Program for a wide range of service options such as: (1) Bone Densitometry only (2) Interpretation of results including therapeutic recommendations based on evaluation of risk factors will be reported to you by our physicianwho has special training and expertise in reading bone densitometry and in osteroporosis. (3) Comprehensive Osteoporosis Consultation Consultation includes densitometry, history, and physical exam by our physician, other diagnostic testing as indicated, and a comprehensive report with recommendations for management and treatment to the referring physician.


Preventive and Support Services

As prescribed by the referring physician, the patient may be coordinated with physical therapy, nutritional counseling and/or lifestyle and safety education.


Osteoporosis Management and Treatment

At the referring physician's request, the patient may be managed and/or treated for osteoporosis through the program under the direction of the program medical director. Periodic progress and outcome reports will be provided to the referring physician during the course of treatment. Management of the patient will be limited to the osteoporosis treatment. The patient will be directed back to the referring physician at all times for any other medical findings or health concerns