As shown in Figure 1(Fig. 1), hyperglycemia and insulin resistance directly decrease osteoblast differentiation and activity by decreasing the expression of osteoblast-related markers, including the Runt-related transcription factor 2 (Runx-2), osteocalcin, bone morphogenetic protein-2 (BMP-2), osteopontin. Here, RUNX2 is linked to Insulin resistance.