Most importantly, hyperglycemia exerts a regulatory effect on osteoblasts and osteoclasts; chronic hyperglycemia reduces the ratio of bone biochemical markers, including osteocalcin, AKP, and procollagen type 1 N terminal propeptide, runt-related transcription factor (RUNX2) (Compston, 2018b). Here, RUNX2 is linked to Hyperglycemia.