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Diabetics: Watch Your Bone Health

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Do you suffer from diabetes? It is doubly important to watch out for the health of your bones. Discover why below.

Researchers find new medical discoveries each day. Over the past few decades, researchers have found that diseases are rarely simply cut-and-dried. Many diseases lead to a host of other problems, as is the case with diabetes and osteoporosis.

According to research, having diabetes puts you at risk for developing osteoporosis. Both type 1 and type 2 lead to lower bone density. According to the National Institute of Health, over 25 million Americans have diabetes. Only about 10 percent have type 1 diabetes, however, which is generally considered a genetic condition. 90 percent of diabetes sufferers have type 2 diabetes, which is a preventable and treatable condition.

The Danger of Osteoporosis

Most people know that osteoporosis is a dangerous condition, but fewer people know why. Osteoporosis causes the bones to become less dense, which increases the risk of fracture. Osteoporosis fractures can result in extreme pain, disability, and even early death. According to The National Institute of Health, there are over 40 million people with lowered bone mass or osteoporosis.

Common Risk Factors
  • Diabetes
  • Medications (like glucocorticoids or cocosteriods)
  • Family history
  • Small bones
  • Lack of exercise
  • Alcohol abuse
  • Smoking
  • Hormonal changes
  • Vitamin and mineral deficiencies

There are also a few diabetes-specific risk factors for poor bone health. A 2004 study published in “Clinical Diabetes” indicated several risk factors for diabetes and osteoporosis.

Metabolic function: Poor metabolic control is a risk factor for bone fractions with diabetes. Individuals with diabetes typically have reduced metabolic function, which leads to slower bone development and faster deterioration.

Reduced Peak BMD: Bone mineral density typically peaks around age 30, but for a person with type 1 or early-onset type 2 diabetes, normal bone development never has a chance to reach typical density levels. This increase the risk for bone problems later in life. Some women with type 1 diabetes also have reduced estrogen levels, which is essential for the normal development process of a woman’s bones.

Eating Disorders: Many patients with diabetes have eating disorders, according to the Clinical Diabetes study. Eating disorders lead to reduced bone density due to the lack of enough nutrition in the diet. Low body weight is a huge predictor of osteoporosis, which is likely in patients with type 1 diabetes.

Fall Risk: Many of the fractures seen due to osteoporosis occur due to falls. Diabetes can contribute to the risk of falls because diabetes leads to complications like impaired vision, poor balance, nerve failure in the legs, and muscle weakness.

Related Diseases: A few other diseases linked with diabetes also lead to a decrease in bone density. Graves’ disease, celiac spruge, celiac disease, and treatments for hypertension and other side effects of diabetes can contribute to a loss of bone mass.

Can Osteoporosis Be Prevented?

Osteoporosis is a disease that is completely preventable. Although bone mass does lower naturally over time, the right activities, diet, and supplements can help increase bone density, or at least prevent it from decreasing. Early detection and screening is helpful for determining the progression of the disease before it is too late and bones are permanently damaged. Healthy habits when a person is still young (usually under 40 years of age) are also important for creating lasting bone health.

How Osteoporosis and Diabetes are Linked

According to the National Institute of Health, both type 1 and type 2 diabetes are linked with low bone density. Some scientists have hypothesized that insulin may promote bone strength and healthy growth. Most people who get type 1 diabetes get it at a young age when bones are first forming.

Researchers think that perhaps the disruption of healthy insulin levels interferes with effective bone development. Most individuals reach peak bone mass around the age of 30. If a person has a lowered bone mass at age 30 (perhaps due to insulin issues), then they are at a greater risk for developing osteoporosis because their bone density is less to begin with.

Low bone density is also linked to a few other diabetes-related problems, like celiac disease. Many children with type 1 diabetes also have celiac disease. Most individuals with celiac disease also show reduced bone mass. Researchers believe that cytokines produced by cells in the body are responsible for the development of issues like type 1 diabetes and osteoporosis.

Type 2 diabetes also increases a person’s osteoporosis risk. High body weight and obesity are a clear cause of reduced bone density. The majority of people with type 2 diabetes are overweight. This contributes to reduced bone strength. Factors like a sedentary lifestyle, overweight frame, and insulin interference all contribute to poor bone health in individuals with diabetes.

A 2002 study conducted by the American Diabetes Association indicated that women who break a bone before the age of 50 have a 74 percent higher chance of breaking additional bones after the age of 50. According to the study, early fracture rates are a good indicator of future bone health. It was found that women with type 1 diabetes have a 12 times higher risk for fractures, and women with type 2 diabetes have a higher fracture rate for the hip, humerus, and foot fractures.

A 2004 study published in Clinical Diabetes Journal highlighted the increase of bone fracture in individuals with diabetes. According to the study, a 10 percent decrease in bone mineral density can lead to a nearly three times greater risk for serious fractures. The study found that 50 percent of diabetes patients showed a reduction in bone density at any age.

Managing Osteoporosis and Diabetes

If you have diabetes, you should take extra care to protect your bone health. Luckily, you can take the same steps to promote healthy bones with diabetes as without it. The only special consideration you have to make is to watch your sugar levels. Dairy products, common providers of calcium and vitamin D, often contain high levels of sugar (particularly the reduced-fat versions). Use the following five strategies to protect your bone health with diabetes:


Bones depend on a variety of nutrients. The main nutrients used for bone health include calcium, Vitamin D, vitamin K, magnesium, potassium, protein, and prosperous. These important nutrients are essential for the development and maintenance of strong, healthy bones. Vitamin D does not build bones directly, but it is important for absorbing enough calcium. Without vitamin D, bone health is severely reduced. You can get most of these nutrients from your diet. Try adding the following foods to your diet to ensure you get enough bone-building nutrients whether you have diabetes or not:

Foods for Bone Health
  • Milk
  • Yogurt
  • Cheese
  • Kale
  • Beans
  • Lentils
  • Beef liver
  • Sweet potatoes
  • Broccoli
  • Barley
  • Spinach
  • Cabbage
  • Fish
  • Nuts
  • Soybeans
  • Okra


Exercise is key to maintaining bone density. Regular exercise can actually help to restore and rebuild bone mass. The National Institute of Health recommends that individuals engage in weight-bearing exercises to maximize bone-strengthening health. These activities include walking or jogging, weight training, dancing, climbing stairs, and most sports. 30 to 90 minutes per day, 3-5 times a week will improve bone health the most. In addition to benefiting bone density, frequent exercise will also help fight obesity, which also leads to poor bone health in individuals with type 2 diabetes.


Both smoking and alcohol can contribute to rapid bone density loss. Combined with diabetes and other bone-reducing habits and conditions, a person who drinks or smokes with diabetes has greatly reduced bone mineral density. Smoking triggers early menopause in women, and it also blocks calcium absorption. Alcohol blocks nutrient absorption and increases fall risks.


Certain supplements can help ensure that you fill in any nutritional gaps in your diet and provide the best bone-building boost to your body. You can supplement with these at any point in life, whether you are at imminent risk for bone density loss or not.

Calcium citrate: Web MD states that calcium citrate is the most absorbable form of the nutrient. It is essential for many bodily functions. However, it is important to be cautious when taking calcium supplements. A study from the University of Aukland in 2012 showed that women who supplemented with calcium without vitamin D were 30 percent more likely to suffer a heart attack. However, a 2012 study conducted by the Fred Hutchinson Cancer Research Center showed that in a 7-year follow up study of 36,282, supplementing with 1,000 mg of calcium and 400 mg of vitamin D led to a 35 percent reduction in hip fractures and no increased risk of heart attacks.

Vitamin D: Vitamin D is essential for bone health. If you plan to supplement with calcium, you should definitely also supplement with vitamin D.

Magnesium: Magnesium is an essential mineral necessary for the development of healthy bones. Many Americans are lacking in this vital nutrient that can make calcium more absorbable, increase energy, and reduce the loss of bone mass.

Vitamin K: Vitamin K is an essential bone-building nutrient. High levels of vitamin K lead to stronger bones and higher bone density. However, few healthy people are deficient in vitamin K, but supplementing with the vitamin doesn’t seem to hurt.

Zinc and Copper: A 2002 study conducted by the University of Central Lancaster indicated that a reduction in both zinc and copper levels due to aging and absorption blockers led to a reduction in bone density in men and women.

Bone Density Tests

If you have diabetes, frequent bone density tests can help you track your bone health before it becomes a problem. BMD tests are particularly helpful for diabetes sufferers on medications that interfere with bone growth (such as glucocorticoids or cocosteriods). The dual-energy x-ray absorptiometry (DXA) test is one of the best tests to use to determine bone density. Speak with your doctor about getting regular BMD tests if you have diabetes so you can catch bone density loss before it leads to fractures and osteoporosis.

Tracking Bone Density with Diabetes

If you have diabetes, it is particularly important to watch your bone health. Diabetes can wreak havoc on the bones, leading to a host of complications. According to The American Academy of Orthopedic Surgeons, one of every two women and one of every four men over the age of 50 will suffer a hip fracture due to osteoporosis. 20 percent of individuals with hip fractures die within one year.

Due to these alarming statistics, it is important to watch your bone health, particularly when dealing with diabetes, which can contribute to many risk factors that make falls likely and increase the risk of osteoporosis. If you have diabetes, taking steps to watch your diet, exercise regularly, and test for both health will help you protect your bone health for the rest of your life. As a bonus, many of these same activities will also reduce the side effects of type 2 diabetes, leading to better health overall.





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