A healthy living blog from Marshfield Clinic Health System

Protect your bones from effects of diabetes

Senior man and senior woman having breakfast, passing a plate stacked with toast - Diabetes and your bones

Controlling blood sugar through diet and exercise helps prevent diabetes complications that increase fracture risk.

Diabetes is known for causing serious side effects including cardiovascular disease, kidney disease, strokes and limb amputations. Unfortunately, your bone health also is at risk if you have diabetes.

“The association between diabetes and osteoporosis remains controversial, but there is evidence that diabetes impacts bone health,” said Dr. Odette Morgan, a Marshfield Clinic endocrinologist.

People who have Type 1 diabetes are at greater risk for low bone density because they have little or no natural insulin. Lack of insulin leads to fragile bones and fractures. It’s believed that higher insulin levels and extra body weight in people with Type 2 diabetes provide some protection for bones.

However, anyone with diabetes is at higher risk for low bone density and fractures.

Diabetes and some medications weaken bones

Research shows diabetes slows bone turnover. That means the body is slow to clear dead bone cells and replace them with new, healthy cells. The result is weaker bones and slower healing of fractures.

Two classes of diabetes medications – SGLT2 inhibitors and thiazolidinediones (TZDs) – have been shown to reduce bone density and lead to osteoporosis. If you take these medications, talk to your doctor about ways to fight bone loss.

Diabetes complications can lead to fractures

Diabetes causes other medical problems that weaken bones and make fractures more likely.

Diabetes is a major risk factor for chronic kidney disease. When too much kidney function is lost, your body can’t effectively filter toxins. This affects your body’s ability to make active vitamin D, which helps you absorb calcium needed for healthy bones.

Diabetic neuropathy is nerve damage that often causes numbness in the feet and legs. Fall risk increases when you have limited feeling in your feet. Charcot joint, an unstable joint condition, causes balance problems when it affects the ankles.

“Numbness and unstable joints make it hard to perform weight-bearing exercises that improve bone health,” Morgan said.

Diabetes can cause a vision problem called retinopathy. Poor eyesight puts patients at greater risk for falls. As fall risk rises, so does the likelihood of fractures.

People who have diabetes are at greater risk for heart attack and stroke. A fall that follows a heart attack or stroke can result in broken bones.

Controlling diabetes protects bones

“Achieving good long-term control of diabetes prevents the complications that increase fracture risk,” Morgan said.

Eating a balanced diet and exercising are important for both controlling diabetes and improving bone health. Incorporate all food groups in your diet, including foods high in protein, calcium, vitamin D, magnesium and phosphorous for strong bones. Regular weight-bearing and light resistance exercises improve bone density.

Take steps to prevent falls, like getting your vision checked, removing loose rugs from your home, and installing good lighting inside and outside your house.

Get regular medical checkups and ask your doctor about a bone density test if you have diabetes.

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