Bone Health and Diabetes: What You Need To Know

This content material initially appeared on diaTribe. Republished with permission.

By April Hopcroft

Key takeaways: 

• Folks with kind 1 and sort 2 diabetes have an elevated threat of growing osteoporosis and experiencing bone fractures.
• Sustaining a wholesome physique weight and consuming a nutritious eating regimen are key to wholesome bones – you’ll want to get sufficient calcium and vitamin D, specifically.
• Different methods to scale back osteoporosis threat embrace participating in common energy coaching and receiving really helpful screenings, and maintaining with blood sugar administration.

Except you’ve lately damaged one thing, bone well being might not be prime of thoughts. However holding bones wholesome is vital, particularly for folks with diabetes, who could also be at larger threat for osteoporosis.

Even should you’ve already been recognized with osteoporosis, it’s by no means too late to start out constructing sturdy bones and stop breaks. We spoke to Dr. Rasa Kazlauskaite, an endocrinologist with intensive expertise in osteoporosis, to know the connection between bone illness and diabetes.

What’s osteoporosis?

Osteoporosis is a situation that causes bones to turn out to be weak and brittle. This will increase the danger of bone fractures from even minor stresses, akin to falling from a standing place and even from coughing, Kazlauskaite mentioned.

Like your pores and skin, bone resides tissue that’s regularly re-growing. Osteoporosis occurs when outdated bone is misplaced sooner than new bone will be created. Usually, folks with osteoporosis don’t discover any signs within the early phases – you may’t really feel your bones getting smaller and thinner. In later phases, chances are you’ll discover lack of top, stooped posture, or damaged bones (generally within the backbone, hip, or wrist). Usually the primary signal of osteoporosis is a fractured bone.

“We hear all about coronary heart assault prevention, however we don’t hear about fracture threat,” Kazlauskaite mentioned.

Whereas many can folks heal shortly from a break with out issues, bone fractures might require a long-term want for crutches, a wheelchair, or a walker – particularly in older adults. Lengthy durations of being motionless can result in many alternative issues and infections, which can take longer to heal with diabetes.

Diabetes-related issues like neuropathy and imaginative and prescient issues may also enhance the danger of fractures, Kazlauskaite mentioned. As an example, peripheral neuropathy can scale back foot energy, which might result in severe falls. Likewise, should you can’t see correctly, chances are you’ll be extra more likely to journey and fall.

Threat elements for osteoporosis

Whereas diabetes doesn’t trigger osteoporosis, it could increase the danger of growing it. Having diabetes (kind 1 or kind 2) additionally will increase the danger of fractures. In kind 1 diabetes, folks are inclined to have low bone mineral density and should have impaired bone formation, each of which might contribute to osteoporosis.

Different threat elements embrace:

• Growing old: Bone progress slows as we age and bone loss occurs sooner, growing the danger for bone illness.
• Organic intercourse: Girls usually are at larger threat for osteoporosis as they have an inclination to have smaller, much less dense bones than males.
• Ethnicity: White and Asian girls ages 50 and older have an elevated threat of osteoporosis attributable to decrease bone density.
• Hormonal adjustments: Girls who’ve gone via menopause are at larger threat of osteoporosis attributable to a drop in estrogen ranges (low estrogen can scale back bone density. Low testosterone may also enhance the danger since testosterone performs a job in holding bones sturdy.
• Low physique weight: Individuals who weigh lower than 125 kilos have a larger threat of osteoporosis.
• Different circumstances: Kidney failure, liver illness, inflammatory bowel illness, arthritis, and consuming issues might contribute to the event of osteoporosis.
• Drugs: Some medication influence calcium absorption and bone formation, probably growing the danger of osteoporosis. This contains diabetes drugs like sulfonylureas, thiazolidinediones, and SGLT-2 inhibitors, in addition to diuretics (water tablets), that are used to handle kidney and heart problems.

5 methods to strengthen bones

Whether or not you’ve got osteoporosis or are attempting to stop it, there are many steps you may take to keep up bone well being long-term.

1. Preserve a wholesome physique weight

Weight administration is a vital facet of osteoporosis prevention. Being underweight or dwelling with weight problems can enhance the danger of thinning bones and fractures.

Usually, folks with smaller frames have a larger threat of osteoporosis as they have an inclination to have much less bone mass. Their bones are additionally extra more likely to turn out to be fragile with age, Kazlauskaite mentioned.

In the meantime, weight problems can enhance the danger of fractures, particularly on the tibia (shinbone), humerus (higher arm), and ankle. Weight reduction – particularly fast weight reduction via bariatric surgical procedure – reduces bone mass, which might enhance the danger of osteoporosis.

2. Follow energy coaching

Whereas energy coaching (additionally known as resistance coaching) is broadly seen as a strategy to construct muscle, it could additionally assist keep wholesome bones and scale back fracture threat.

Any type of weight-bearing train – strolling, working, dancing, and even pickleball – will put pressure in your bones and assist strengthen them. Weight-bearing workouts assist stimulate bones to resume themselves, Kazlauskaite defined.

A 2022 examine discovered that resistance coaching elevated bone mineral density in girls who had gone via menopause. Energy workouts like weight lifting additionally enhance posture and steadiness, which may also help stop falls. In case you use free weights or weight machines, it’s a good suggestion to start out small and construct up slowly.

You’ll want to put on correct sneakers for any bodily exercise, Kazlauskaite mentioned, as folks with diabetes are at an particularly excessive threat of fractures within the ankle and tibia. Diabetes-related foot issues akin to Charcot foot could also be associated to fractures which have gone unnoticed. In case you’re unable to train attributable to accidents, Kazlauskaite really helpful packages akin to Osteostrong.

3. Eat a calcium-rich eating regimen

Bear in mind being informed as a child to complete your milk as a result of it builds sturdy bones? That’s as a result of milk accommodates calcium, a mineral that helps type bones and maintain them sturdy. Good sources of calcium embrace milk, cheese, yogurt, seeds, beans and lentils, leafy greens, and fish.

Kazlauskaite really helpful monitoring your calcium consumption via an app like My Health Pal or MyNetDiary. Ideally, it is best to devour no less than 1,000 mg of calcium per day, she mentioned. Individuals who have gone via menopause might have larger calcium wants (round 1,200 mg per day).

In case you’re not in a position to get sufficient calcium via your eating regimen, dietary supplements may also help. Most individuals begin with calcium citrate, however chances are you’ll wish to think about calcium phosphate should you expertise unintended effects from calcium citrate, Kazlauskaite suggested.

4. Get sufficient vitamin D

Vitamin D can also be vital for sturdy bones because it helps your physique take up calcium. Good sources of vitamin D embrace egg yolks, mushrooms, and sure fish like salmon, tuna, and sardines. A number of meals are fortified with vitamin D, together with milk, orange juice, cereal, and oatmeal.

In case you are taking vitamin D dietary supplements, Kazlauskaite recommends getting your ranges checked so you realize the place issues stand. For osteoporosis prevention, vitamin D ranges must be no less than 30 ng/mL. Over-the-counter vitamin D dietary supplements can be found at most drugstores and grocery shops.

If for any purpose your healthcare supplier isn’t in a position to supply vitamin D testing, Kazlauskaite steered the web site walkinlab.com, which lets you join low-cost testing by yourself.

5. Get screened for osteoporosis

For folks with diabetes, bone mineral density scans are normally really helpful for girls once they enter menopause and for males round age 50, in line with the American Diabetes Affiliation.

As a result of larger likelihood of fractures, folks with diabetes have to be examined for bone fracture threat, Kazlauskaite mentioned. This contains the FRAX threat calculator, testing for falls, and analysis with laboratory assessments and a bone density (DXA) scan.

For folks with kind 1 diabetes, DXA scans are really helpful on the time of analysis and each 2-5 years. The bone density testing should embrace trabecular bone rating (TBS), Kazlauskaite famous.

Therapy for osteoporosis

In case you’ve been recognized with osteoporosis, remedy might contain drugs and life-style adjustments. Widespread drugs to deal with osteoporosis are bisphosphonates like alendronate. One other remedy is denosumab, an injection given each six months. Apparently, new analysis exhibits alendronate and denosumab might scale back the danger of growing kind 2 diabetes.

Hormone remedy could also be really helpful for girls who’ve gone via menopause or folks with low testosterone. As with osteoporosis prevention, an vital a part of remedy is holding bones sturdy and wholesome – this contains getting common train, consuming nutritiously, and sustaining a wholesome weight.

The underside line

It’s by no means too early to start out fascinated by osteoporosis and taking steps to strengthen your bones. Managing your diabetes via wholesome life-style adjustments and holding blood glucose ranges in goal vary can go a good distance towards lowering your threat of issues, together with osteoporosis.