The relationship between diabetes and osteoporosis

People with diabetes, particularly with type 1 diabetes, often have a lower bone quality and an increased risk of fractures. People who have had the disease for a long time, who have poor blood sugar control and who take insulin have the highest risk of fractures.

The onset of type 1 diabetes usually occurs at an early age when bone mass is still on the rise. People with type 1 diabetes may have a lower maximum bone mass. The maximum bone mass is the maximum strength and density that the bones reach. People typically reach their peak bone mass between the ages of 20 and 30. When the peak of bone mass is low, it can increase the risk of osteoporosis later in life.

Some of the complications of diabetes, such as nerve damage, muscle weakness, episodes of low blood sugar, and vision problems can increase the risk of falls and fractures.

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Managing osteoporosis

Strategies for preventing and treating osteoporosis in people with diabetes are the same as for people without diabetes.

Nutrition. A diet rich in calcium and vitamin D is important for healthy bones. Some good sources of calcium include low-fat dairy products, dark green leafy vegetables, and calcium-enriched beverages and foods. There are many sources of calcium that are low in fat and sugar. In addition, supplements can help meet daily calcium and other important nutrients requirements.

Vitamin D plays an important role in calcium absorption and bone health. It is synthesized in the skin through exposure to sunlight. Although many people manage to get enough vitamin D naturally, older people are often deficient in this vitamin, in part, due to the limited time they spend outdoors. Vitamin D supplements may be needed to ensure adequate daily intake.

Exercise. Like muscles, bones are living tissues that respond to exercise by becoming stronger. The best exercises for the bones are those that require sustaining their own weight and those of endurance. Exercises that require holding one’s weight make one strive to work against gravity. These include walking, climbing stairs and dancing. Resistance exercises, such as lifting weights, can also strengthen bones. Regular exercise can help prevent bone loss and, by improving balance and flexibility, can reduce the risk of falls and bone fracture. Exercise is especially important for people with diabetes, as exercise helps lower blood glucose levels.

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Healthy lifestyle. Smoking is bad for the bones as well as for the heart and lungs. Women who smoke tend to go through menopause earlier, causing bone loss at a younger age. In addition, people who smoke may absorb less calcium from their diets. Alcohol can also negatively affect bone health. People who drink excessively are more prone to bone loss and fractures. Avoiding tobacco and alcohol can also help with diabetes management.

Bone density test. Specialized tests known as bone mineral density (BMD) tests that measure bone density in various parts of the body. These tests can detect osteoporosis before a bone fracture occurs and predict a person’s chance of breaking a bone in the future.

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This test can measure the bone density of your hip or spine. People with diabetes should talk to their doctors to see if they are candidates for bone density testing.

Medications. As with diabetes, there is no cure for osteoporosis. However, there are some drugs that have been approved by the U.S. Food  and  Drug  Administration for the prevention and treatment of osteoporosis in postmenopausal women and in men. The drugs have also been approved for use in both women and men with glucocorticoid-induced osteoporosis.

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