Diabetes and Bone Health: Know the Connection Between Them

Introduction

Diabetes mellitus (a group of diseases causing high blood glucose levels in the blood) is commonly known as diabetes. There are various potential complications for diabetes mellitus, like eye problems and heart and kidney diseases, but studies have shown that bone is also affected by diabetes mellitus. Comparatively, people with type 1 and type 2 diabetes are more prone to bone disease than those without diabetes. People with diabetes mellitus are affected by various bone diseases, especially in the hip area. Studies have shown that measures taken to reduce diabetes may also reduce the risk of bone diseases.

What Is Diabetes?

Diabetes is a medical condition that occurs when the body's metabolism changes. It is a metabolism disorder, which means that the body's metabolism process fails or causes the body to produce more or less of the substances it needs to stay healthy. In diabetes mellitus, the substance is insulin. Here, the metabolism starts when the glucose from the digested food enters the bloodstream.

The glucose provides energy to the cells to perform various activities. It needs the insulin hormone to enter the bloodstream and provide energy to the cells. Insulin is formed in the pancreas, which transfers glucose from the bloodstream to the cells to provide oxygen for living. In people with diabetes, the body may produce more or less insulin.

Thus, it affects the metabolism and results in such a condition. Diabetes comes in two types.

• Type 1 Diabetes: It produces less or no insulin and is more common in young adults and children.

• Type 2 Diabetes: It produces no insulin or has no response to the insulin produced. Type 2 diabetes is common in older individuals.

How Does Diabetes Affect Bone Health?

Many studies have established that both type 1 and type 2 diabetes affect the bone and cause an increased risk of fracture, especially the hip bone. Some of the clinical indications that link diabetes and bone health are as follows:

• Increased oxidative stress (imbalance of antioxidants and free radicals in the body leading to cell damage) in the body due to diabetes may affect bone health.

• Reduced release of hormones like IGF-1 (insulin-like growth factor - 1) that promote the growth of bones, skeletal muscles, and cartilage.

• Diabetes may affect the bones due to reduced absorption of calcium.

• The causes of bone disease may also be due to increased glycation in diabetes patients. Glycation is the process where glucose molecules bind with fats and proteins.

• Patients with diabetes may have increased loss of calcium in urine, which may lead to bone defects.

• Increased levels of parathyroid hormone in diabetes patients may also cause a lack of calcium, which leads to bone problems.

All these indications can result in decreased bone quality and strength, thereby increasing the risk of bone fracture. This may cause certain bone diseases in people with diabetes.

What Are the Bone Diseases Linked to Diabetes?

Bone disease refers to any condition that damages the bone and makes it weak enough to get fractures. Bone diseases that are linked with diabetes include:

1. Osteoporosis

Osteoporosis is a common bone disease characterized by structural deterioration of the bone tissues and reduced bone mass. It may cause bone instability and hip, knee, wrist, and spine fractures. It most often affects older people, and it is a treatable disease. Low bone density is a major effect of osteoporosis that happens when bone loses its vital minerals, mainly calcium. Due to calcium loss, the bones may become weak and break easily.

Diabetes and osteoporosis are closely related. Individuals with diabetes face an increased risk of osteoporosis due to factors such as insulin resistance, inflammation, and the impact of certain diabetes medications on bone density and strength. Maintaining a balance between glucose regulation and bone health is important, as an imbalance can contribute to the development of osteoporosis. Regular monitoring, a balanced diet, and adequate calcium and vitamin D intake are vital components in managing diabetes patients who are more susceptible to osteoporosis.

2. Osteopenia

The bones get weaker in osteopenia. It presents between strong, healthy bones and osteoporosis. Bone density and mass are unaffected, so it does not easily cause bone breakage. Studies have shown that osteopenia is the most common potential complication of type 1 diabetes, especially in people who take high insulin doses.

3. Diabetic Hand Syndrome

It is also called diabetic neuroarthropathy. It is an effect of both type 1 and type 2 diabetes. It causes limitations in finger movements and makes the hands thick and waxy. It is more common in people with uncontrolled diabetes.

4. Frozen Shoulder

It is also known as adhesive capsulitis. It happens when the ligaments in the shoulder become stiff and inflamed. It is a painful condition treated with anti-inflammatory drugs, physical therapy, and corticosteroid injections.

5. Charcot Foot

Charcot foot is also called Charcot neuropathic osteoarthropathy. It is a deformity of the ankle and foot. It causes swelling and redness in the foot. Assistive devices and custom-made shoes can treat it.

6. Dupuytren's Contracture

It is a hand condition also known as palmar fascia. It makes the connective tissue of the hands under the skin thick. It makes the fingers curl and bend towards the palms. It is common in people with type 1 diabetes.

7. Diffuse Idiopathic Skeletal Hyperostosis (DISH)

It is also called Forestier disease. It affects the ligaments and tendons of the spinal cord. It causes bone spurs in the knees, hips, shoulders, hands, and spinal cord.

What Are the Ways to Reduce the Risk of Bone Disease in Diabetic patients?

The best route to prevent bone disease in diabetic patients is to suggest a balanced diet, routine exercises, and a healthy lifestyle.

• Balanced Diet: A balanced diet includes vegetables, fruits, fish, lean meat, nuts, seeds, whole grains, and low-fat dairy products. It may also include calcium-rich foods.

• Routine Exercises: Strengthening exercises and weight-bearing exercises that help to maintain bone health are jogging, stair climbing, dancing, walking, and playing games.

• Healthy Lifestyle: People should quit tobacco, alcohol, and tobacco products that may cause potential bone loss and increase the risk of fractures.

How Can One Adopt Simple Lifestyle Tips to Protect the Bones?

Adopting some simple lifestyle changes can help protect the bone. These include:

• Maintain a Healthy Weight: Always maintain an ideal body weight.

• Eat a Balanced Diet: Consume a diverse, nutrient-rich diet or follow a diet plan by a dietician or health care provider.

• Get Enough Calcium and Vitamin D: Include calcium-rich foods in each meal or snack. Consult the healthcare provider about meeting the vitamin D needs; one might need a supplement.

• Stay Physically Active: Engage in regular physical activity to build strong bones in youth, slow bone loss in adulthood, and enhance muscle strength, posture, and balance at all ages.

• Avoid Smoking and Limit Alcohol: Say no to smoking and alcohol intake. This helps prevent bone loss.

• Prevent Falls: Take steps to prevent falls, like adding lights in the home, removing tripping hazards, and having regular eye and hearing check-ups.

• Bone Mineral Density Test: Diabetes patients, postmenopausal women, and men over 50 should consult their healthcare provider about when to have a bone mineral density (BMD) test. This test can detect osteoporosis before a fracture occurs.

Conclusion:

If the person is diagnosed with diabetes, they must consult healthcare providers as soon as possible to prevent certain bone diseases. Keeping the blood glucose level normal with medications may help the person with diabetes avoid bone diseases. Thus, it is essential to consider bone health in patients with diabetes. Reaching out to healthcare professionals may be beneficial.