“…For instance, Graves and colleagues have elegantly demonstrated in ligature, calvarial and bone fracture models (in the presence and absence of infection) that hyperglycemia and TNF-α affect fibroblast and osteoblast apoptosis which contributes to in vivo cartilage and bone loss in models of type 2 diabetes and hyperglycemia (Alblowi et al, 2009; Alikhani et al, 2007; Desta et al,; Graves et al, 2005; He et al, 2004; Kayal et al, 2009; Kayal et al,; Kayal et al, 2007; Liu et al, 2006; Liu et al, 2004; Lu et al, 2003; Santana et al, 2003; Siqueira et al).While our data demonstrates an osteoclast-specific augmented function in the absence of hyperglycemic contributions, it is plausible that hyperglycemia may further contribute to osteoclast hyperactivity in T1D. Indeed, glucose is the primary energy source of the osteoclast and has been shown to augment osteoclast-mediated resorption via increases in V-ATPase expression (Larsen et al, 2005; Larsen et al, 2002). Furthermore, lack of insulin, now considered to be a bone anabolic agent, leads to decreased bone formation in patients with T1D (Thrailkill et al, 2005).…”