Does diabetes affect bone health?

Self Care, Diet and Nutrition, Bone Health

Girl in a blue sweater pointing to a skeleton.

Yes. It can.

In some cases, diabetes can make your bones more fragile and put you at a higher risk for fracture.F

First, let’s review a few facts about diabetes.

Illustration of how diabetes increases blood sugar levelsDiabetes is a metabolism disorder that occurs when the body cannot produce enough insulin to lower and balance the body’s blood sugar (glucose) levels.

  • Type 1 diabetes occurs when the body no longer produces insulin on its own. This condition requires insulin and cannot be reversed.
  • Type 2 diabetes occurs when cells in the body become resistant to insulin or the body does not produce enough insulin, which prevents the sugar from moving into the cells.
  • There is also a third condition on the horizon, known as prediabetes. The condition is diagnosed when blood sugar is higher than normal (140 mg/dL), but lower than the diabetes threshold (200 mg/dL). Without changes in lifestyle or medical treatment, prediabetes can quickly lead to type 2 diabetes.

According to 2020 figures from the Centers for Disease Control and Prevention (CDC), 10.5% of the U.S. population has diabetes, and 34.5% has prediabetes.

Wisconsinites with the disease are close to the national average. Based on 2018 statistics from the Wisconsin Department of Health Services, Division of Public Health, Chronic Disease Prevention Program, 9 % of Wisconsinites have diabetes and 34% have prediabetes.

So, now that we know what diabetes is, let’s look at how it affects the bones.

How does diabetes affect the bones?

Decreased bone health is “an underappreciated complication of diabetes,” according to The Endocrine News, a publication of endocrine.org.

But surprisingly, low bone mineral density may not be the culprit, at least in people who have a high body mass index (BMI). People who are overweight or obese have normal bone mineral densities.

Yet, all people who suffer from diabetes – no matter their BMI – still have an increased risk of bone fracture.

Some reports suggest the effect of glucose on the bone-building enzymes leads to fragile bones. Other experts believe collagen glycation—a process where sugar molecules adhere to the collagen—making it hard for bone cells to use this protein for the normal growth, function, and replacement of bone cells is the cause.

Another factor leading to bone weakness is diabetes’s negative impact on the kidneys, resulting in a loss of calcium in the bones.

Man with a blue shirt with a broken leg sitting on a couch with crutches.The impact of diabetes on bone health is especially concerning as more children develop prediabetes and Type 2 diabetes. Scientists do not know how high blood-sugar levels affect skeletal growth, which stores the necessary bone minerals needed later in life.

More research is needed to identify the effects of glucose exposure on bone development.

People who have had a long-term diagnosis of diabetes seem to be more at risk for complications that cause fractures.

Diabetes also elevates the risk of microvascular disease, leading to peripheral neuropathy, foot ulcers, and numbness in the feet and legs.

These conditions, along with diabetes-related vision problems, like retinopathy, and fainting from low blood sugar increase the risk of falls and fractures. Blood-sugar control is critical to minimize the severity of these diabetes-related conditions.

Can the risk of bone fragility and fracture from diabetes be prevented?

In some cases, lifestyle changes can help minimize the harmful impact diabetes has on bone health. Here are five areas to consider:

  • Maintaining healthy blood sugar levels helps reduce the effects of diabetes on the entire body.

  • Learning about the side effects of diabetes medications and avoiding those that interfere with bone development and reformation will help keep bones stronger.

  • Eating a healthy diet full of nutritious whole foods – fruits, vegetables, whole grains, nuts, and seeds – while limiting sugar and simple carbohydrates can help regulate blood sugar levels.

  • Adding vitamin D, magnesium, vitamin K2, and other bone-building supplements may help the bone remodeling process, leading to stronger bones.

  • Becoming more physically active and taking part in weight-bearing exercises – like walking, jogging, stair climbing, or weight training – can help improve circulation, especially in the bones, feet, and legs.

Of course, before changing diet, exercise routines, or taking supplements, people should talk to their health care provider to make sure these changes fit with their overall health care plan, especially if they have been diagnosed with diabetes or prediabetes.

Sources:

https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
https://www.dhs.wisconsin.gov/publications/p01897.pdf
https://endocrinenews.endocrine.org/diabetes-bones-underappreciated-complication/
https://link.springer.com/article/10.1007/s00198-006-0155-https://link.springer.com/article/10.1007%2Fs00223-016-0229-0
https://care.diabetesjournals.org/content/43/Supplement_1/S37
https://care.diabetesjournals.org/content/43/10/2544

 

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