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Diabetes And Bone Health

Preserving Bone Health With Type 2 Diabetes

Preserving Bone Health With Type 2 Diabetes

Everyday Solutions are created by Everyday Health on behalf of our partners. More Information Content in this special section was created or selected by the Everyday Health editorial team and is funded by an advertising sponsor. The content is subject to Everyday Healths editorial standards for accuracy, objectivity, and balance. The sponsor does not edit or influence the content but may suggest the general topic area. Preserving Bone Health With Type 2 Diabetes Maintaining strong bones is an important part of managing diabetes. Find out why and learn how to keep bones healthy through diet and exercise. Diabetes affects your blood sugar, but it can have many other consequences including weaker bones. Poor bone health can have a direct relationship to diabetes as well as be a result of other diabetes complications . The first link to bone health and diabetes is osteoporosis, a condition that leads to thinning bones. Both osteoporosis and diabetes are common: Osteoporosis affects about 40 million Americans, and about 26 million Americans have diabetes. In addition, both the risk of developing type 2 diabetes and osteoporosis increase with age. In fact, everyone loses bone density and muscle mass as they get older, and therefore become more prone to bone fractures. Thats why staying physically active is so important as you age it not only helps keep diabetes complications at bay, but also helps maintain strong bones. According to a review of diabetes and bone health published in the journal Diabetes/Metabolism Research and Reviews, type 1 and type 2 diabetes are also associated with an increased risk of osteoporosis, as well as bone fractures. The review found that fractures of the hip, arm, foot, and spine are all more common in people with diabetes. The susceptibility t Continue reading >>

Diabetes Mellitus And Bone Health: Epidemiology, Etiology And Implications For Fracture Risk Stratification

Diabetes Mellitus And Bone Health: Epidemiology, Etiology And Implications For Fracture Risk Stratification

Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice. Osteoporosis is a systemic disease, which confers decreased bone strength and increased fracture risk [ 1 3 ]. Hip fractures especially are a major source of morbidity and mortality in older populations [ 4 ] and present an increasing public health burden [ 5 ]. Diabetes mellitus type 2 accounts for 9095% of the incidence of diabetes [ 6 , 7 ] and its prevalence is increasing worldwide [ 8 ]. Type 2 diabetes mellitus (T2DM) is associated with an increased bone mineral density (BMD) but a paradoxically increased risk for skeletal fractures [ 9 11 ]. Type 1 diabetes mellitus (T1DM) is less prevalent, but its incidence is rising, especially in the very young [ 12 ] and it has also been associated with increased fracture risk [ 13 ]. The causative mechanisms for this association are the subject of study by several groups but have not been completely elucidated. This article aims to evaluate the relationship of diabetes etiology, duration and glucose control with BMD and skeletal fracture. We also discuss potential strategies that increase the accuracy of fracture risk estimates in populations with diabetes mellitus, which Continue reading >>

Diabetes And Bone Health: Latest Evidence And Clinical Implications

Diabetes And Bone Health: Latest Evidence And Clinical Implications

Diabetes and bone health: latest evidence and clinical implications We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Diabetes and bone health: latest evidence and clinical implications Vikram Sundararaghavan, Matthew M. Mazur, [...], and Nabil A. Ebraheim As the prevalence of diabetes is increasing worldwide, research on some of the lesser-known effects, including impaired bone health, are gaining a lot of attention. The two most common forms of diabetes are type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). These two differ in their physiology, with T1DM stemming from an inability to produce insulin, and T2DM involving an insufficient response to the insulin that is produced. This review aims to highlight the most current information regarding diabetes as it relates to bone health. It looks at biochemical changes that characterize diabetic bone; notably increased adiposity, altered bone metabolism, and variations in bone mineral density (BMD). Then several hypotheses are analyzed, concerning how these changes may be detrimental to the highly orchestrated processes that are involved in bone formation and turnover, and ultimately result in the distinguishing features of diabetic bone. The review proceeds by explaining the effects of antidiabetes medications on bone health, then highlighting several ways that diabetes can play a part in other clinical treatment outcomes. With diabetes negatively affecting bone hea Continue reading >>

Diabetes, Bones - Diabetes Self-management

Diabetes, Bones - Diabetes Self-management

Osteoporosis is the most common type of bone disorder, affecting an estimated 10 million Americans. It is a chronic condition characterized by reduced bone strength, low bone mass, and a higher risk of bone fracture, especially at the hip, spine, and wrist. If you are over the age of 50, there is a 55% chance that you are at increased risk for osteoporosis or have it already. The risk of osteoporosis increases with age; it is not, however, limited to older individuals. Osteoporosis can be prevented or slowed down, but once damage to the bone has taken place, it can be difficult to reverse. Bone fractures are the main consequence of osteoporosis, and they are associated with lasting disability after they occur, especially hip fractures in older people. For reasons that are still unclear, people with both Type 1 and Type 2 diabetes experience a higher incidence of bone fracture than the general population, even though people with Type 2 diabetes tend to have above-average bone density. It is especially important, then, for people with diabetes to know about osteoporosis, to have their risk of fracture evaluated by medical professionals, and to find out what they can do to make their bones as strong and healthy as possible. One way health-care providers evaluate a persons risk of osteoporosis is to do a bone mineral density (BMD) test. The most common test uses x-ray beams, is painless, and can be done in a matter of minutes. BMD is a core indicator of bone strength. A test for BMD measures the amount of a mineral, usually calcium, in a bone. This measurement is then compared to the pooled measurements of a group of healthy young adults using a statistical indicator called a standard deviation. If the BMD of the person being evaluated is 2.5 standard deviations or more be Continue reading >>

The Impact Of Diabetes On Bone Health

The Impact Of Diabetes On Bone Health

Diabetes care revolves around controlling blood sugar (glucose) to reduce what we recognize as diabetes complications those relating to vision, to nerve function, to kidney function and to the vessels of the heart, vessels leading to the brain, and the vessels in the legs. What is not so well recognized is that there is also an issue of bone health when most people think of possible complications of diabetes. Osteoporosis is a condition in which there is generalized thinning and weakening of your bones, which puts you at risk of a bone fracture. Osteoporosis is very common, affecting nearly 10 million Americans. Among all Caucasian women, one out of every two have a risk of having an osteoporosis-associated fracture in their lifetime. It doesnt help that as we all get older, bone health plays a larger and larger role for everyone, even more so if you have also been diagnosed with diabetes. Diabetes adds to an increased risk of fractures. And having diabetes can delay fracture healing if fracture occurs, a double hit. But how does diabetes affect the quality of bone and increase the risk of fracture? Is it just diabetes itself, or other complications of diabetes such as neuropathy (nerve damage)? Or is it the medications that are used to control blood sugars? Lets look at the evidence. What is the link between bone density and diabetes? Bone mineral density (BMD) measures the calcium content of the bone, predicting bone strength and fracture risk. The lower the bone density, the higher the risk of fracture. BMD is measured by a special scan called dual-energy X-ray absorptiometry (DXA). BMD as measured by DXA is decreased in Type 1 diabetes (T1D, the diabetes in which your pancreas does not make insulin), but may be actually normal or even increased in Type 2 diabetes ( Continue reading >>

Bone And Joint Problems Associated With Diabetes

Bone And Joint Problems Associated With Diabetes

If you have diabetes, you're at increased risk of various bone and joint disorders. Certain factors, such as nerve damage (diabetic neuropathy), arterial disease and obesity, may contribute to these problems — but often the cause isn't clear. Learn more about various bone and joint disorders, including symptoms and treatment options. Charcot joint What is it? Charcot (shahr-KOH) joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage — a common complication of diabetes. Charcot joint primarily affects the feet. What are the symptoms? You might have numbness and tingling or loss of sensation in the affected joints. They may become warm, red and swollen and become unstable or deformed. The involved joint may not be very painful despite its appearance. How is it treated? If detected early, progression of the disease can be slowed. Limiting weight-bearing activities and use of orthotic supports to the affected joint and surrounding structures can help. Diabetic hand syndrome What is it? Diabetic hand syndrome, also called diabetic cheiroarthropathy, is a disorder in which the skin on the hands becomes waxy and thickened. Eventually finger movement is limited. What causes diabetic hand syndrome isn't known. It's most common in people who've had diabetes for a long time. What are the symptoms? You may be unable to fully extend your fingers or press your palms together flat. How is it treated? Better management of blood glucose levels and physical therapy can slow the progress of this condition, but the limited mobility may not be reversible. Osteoporosis What is it? Osteoporosis is a disorder that causes bones to become weak and prone to fracture. People who have type 1 diabetes have an increased risk of osteoporosis. What are Continue reading >>

Bone Health And Diabetes

Bone Health And Diabetes

The association between diabetes and bone health has long been a matter of debate. Both type 1 diabetes and type 2 diabetes have been linked to increased risk of fractures, with bonemineral density being decreased in type 1 diabetes and increased in type 2 diabetes. Insulin has an anabolic effect on bone, and the qualitatively different effects of type 1 and type 2 diabetes on bone mass are consistent with the opposite insulin-secretory states (hypoinsulinemia vs hyperinsulinemia). The existence of an elevated fracture risk in type 2 diabetes, despite the underlying hyperinsulinemia, has led to speculation about differences in bone quality between type 1 diabetes and type 2 diabetes. This could be explained by the fact that increased blood glucose levels are associated with increased urinary calcium loss, resulting in a negative calcium balance. There is also speculation about the role of the resistance to parathyroid hormone observed in diabetes, and its effect on calcium and bone turnover. Also, collagen glycosylation may alter bone biomechanical competence. Falls associated with diabetes-related comorbidities are another possible cause of low-trauma fractures. Adequate glycemic control and prevention of diabetic complications are the mainstay of therapy to lower fracture risk, with the caveat that thiazolidinediones increase fracture risk in postmenopausal women with type 2 diabetes. In conclusion, bone health is an important consideration in diabetes, and caution should be exercised in prescribing thiazolidinediones to postmenopausal women with low bonemass and patients with prior fragility fracture. This article reviews the current state of knowledge on the association between diabetes and bone health. Medicographia. 2010;32:364-369 (see French abstract on page 36 Continue reading >>

Bone Health And Diabetes

Bone Health And Diabetes

One of the many reasons to eat well and be physically active is to preserve bone health. This is particularly important for those with diabeteswhether you are a man or a woman, have type 1 diabetes or type 2. People with type 1 diabetes tend to have low bone density, which increases the risk of osteoporosis and fractures. Although those with type 2 diabetes are often overweight, which is associated with higher bone density, they too are prone to fractures. Plus, everyone loses bone density and muscle mass with age. With diabetes, particularly if you have complications such as neuropathy (nerve damage) or vision problems, there could also be balance issues, says Jacqueline Shahar, M.Ed., RCEP, CDE, a certified diabetes educator and manager of exercise physiology in the Joslin Clinic . A healthy diet with plenty of calcium and vitamin D and regular weight-bearing exercise are key to slowing bone loss, improving balance, and preventing falls and injuries. You need to strengthen bones and muscles to avoid falling injuries, which improves your daily functioning and quality of life, Shahar says. The easiest weight-bearing exercise is walking. Lifting weights, jogging, biking and dancing are other examples. But the solution could be as simple as doing a chair squat, standing heel raises and the step-up . Just getting up from a chair and sitting back down or stepping up on a stair or flight of stairs builds up bones, strengthens the muscles around the bones, and improves balance, Shahar says. But dont wait until age 50 or 60, she says. An active lifestyle is a lifelong part of preserving bone health and managing diabetes." To make an appointment with Jacqueline Shahar, call 617-732-2400. Continue reading >>

Bone Health In Type 1 Diabetes: Where We Are Now And How We Should Proceed

Bone Health In Type 1 Diabetes: Where We Are Now And How We Should Proceed

Bone Health in Type 1 Diabetes: Where We Are Now and How We Should Proceed 1Department of Clinical Sciences and Community Health, University of Milan, Unit of Endocrinology and Metabolic Disease, Foundation IRCCS C Granda, Ospedale Maggiore Policlinico, Padiglione Granelli, F. Sforza Street, No. 35, 20122 Milan, Italy 2Belarusian State Medical University, Dzerzinski Avenue, No. 83, 220116 Minsk, Belarus Received 16 January 2014; Accepted 30 May 2014; Published 25 June 2014 Copyright 2014 Volha V. Zhukouskaya et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Type 1 diabetes (T1D) is autoimmune disease with chronic hyperglycaemic state. Besides diabetic retinopathy, nephropathy, and neuropathy, T1D is characterized by poor bone health. The reduced bone mineralization and quality/strength, due to hyperglycemia, hypoinsulinemia, autoimmune inflammation, low levels of insulin growth factor-1 (IGF-1), and vitamin D, lead to vertebral/hip fractures. Young age of T1D manifestation, chronic poor glycemic control, high daily insulin dose, low BMI, reduced renal function, and the presence of complications can be helpful in identifying T1D patients at risk of reduced bone mineral density. Although risk factors for fracture risk are still unknown, chronic poor glycemic control and presence of diabetic complications might raise the suspicion of elevated fracture risk in T1D. In the presence of the risk factors, the assessment of bone mineral density by dual-energy X-ray absorptiometry and the search of asymptomatic vertebral fracture by lateral X-ray radiography of thorax-lumbar spine should be recommended. The i Continue reading >>

Osteoporosis And Diabetes

Osteoporosis And Diabetes

People with type 1 diabetes are most susceptible to osteoporosis People with type 1 diabetes tend to have a lower bone density and hence at an increased risk of osteoporosis, a condition resulting in weakened bones. Osteoporosis is believed to affect around 3 million people in the UK. Our bones weaken as we get older but some factors can speed up the loss of bone density. Osteoporosis may not present noticeable symptoms and the first indication that you may have osteoporosis is usually if you suffer a bone fracture. Osteoporosis may be noticeable in older as weak and fractured bones in the spine can cause the head to permanently lean forwards and a hunchback appearance developing. Common bone fractures resulting from osteoporosis include: Osteoporosis can be diagnosed using a DEXA scan, which measures your bone mineral density (BMD). DEXA stands for dual energy X-ray absorptiometry. There are three different different grades of bone density, normal, osteopenia and osteoporosis. Osteopenia is where you have lower than normal bone density but a higher bone density, and therefore lower risk of fractures, than osteoporosis. Our bones generally become weaker as we get older but a number of factors can speed up the weakening of bones and include: Being bed bound or otherwise getting very little physical activity Overactive thyroid gland (hyperthyroidism) Higher rates of osteoporosis have been noted in people with type 1 diabetes. People with type 1 diabetes have been found to have, on average, lower bone mineral density. Researchers are yet to fully understand the mechanism to explain why people with type 1 diabetes have a lower bone density but one hypothesis is that insulin may play a part as our bones are known to play a part in the regulation of blood sugar levels. Read Continue reading >>

What People With Diabetes Need To Know About Osteoporosis

What People With Diabetes Need To Know About Osteoporosis

What People With Diabetes Need to Know About Osteoporosis What People With Diabetes Need to Know About Osteoporosis Diabetes is a disorder of metabolism, a term that describes the way our bodies chemically change the foods we eat into growth and energy. After we digest food, glucose (sugar) enters the bloodstream, where it is used by the cells for energy. For glucose to get into the cells, insulin must be present. Insulin is a hormone produced by the pancreas, an organ located behind the stomach. It is responsible for moving glucose from the bloodstream into the cells to provide energy needed for daily life. In people with diabetes, the body produces too little or no insulin or it does not respond properly to the insulin that is produced. As a result, glucose builds up in the blood and may overflow into the urine where it is excreted from the body. Therefore, the cells lose their main source of energy. According to the Center for Disease Control and Prevention, 29.1 million people have diabetes. In type 1 diabetes, the body produces little or no insulin. This form of the disease typically appears in children and young adults, but it can develop at any age. In type 2 diabetes, the body produces insulin but not enough, and the body does not respond properly to the insulin that is produced. This form of the disease is more common in people who are older, overweight, and inactive. Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in pain and disability. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass. Risk factors for developing osteoporosis include: for women, being postmenopausal, having an early menopause, or not Continue reading >>

What Is The Connection Between Diabetes And Bone Health?

What Is The Connection Between Diabetes And Bone Health?

What Is the Connection Between Diabetes and Bone Health? What Is the Connection Between Diabetes and Bone Health? For African Americans, diabetes is a serious health concern, affecting 12.7% of the population [1] . Most people recognize the complications of diabetes, such as heart disease, stroke, neuropathy, and eye problems, but did you know that people with diabetes are at an increased risk of breaking a bone? In 2017, Jennifer Walsh published an article looking at type 2 diabetes and bone in adults. [2] People with Type 2 diabetes typically have higher bone density, due to increased body weight, so they may not get diagnosed with osteoporosis or low bone density that would trigger steps to prevent fractures and reduce the chance of fractures. However, there is a 1-2 times greater chance of fractures for people with diabetes [3] . What accounts for this increase in risk of fracture is still being studied, but there is emerging evidence that the excess sugar in the bloodstream attaches to the collagen the bone. The reason this is important is that the collagen in the bone makes the bone tougher and less likely to break when it has a force put on it, like a fall. When the sugar attaches to the collagen, it creates structural changes that make the bone less flexible and more brittle. [4] , [5] Researchers who have looked at the properties of bone in people with type 2 diabetes have found that the strength of the bone in these patients is 10% less than is patients without type 2 diabetes. [6] There is also some evidence that treatments for diabetes, such as Metformin, can reduce the risk of fracture, while others like TZDs and glitazones, actually increase the risk of fracture. [7] The bottom line is that people with type 2 diabetes need to be concerned about their bone Continue reading >>

Just What Is The Link Between Diabetes Mellitus And Osteoporosis And Bone Fractures?

Just What Is The Link Between Diabetes Mellitus And Osteoporosis And Bone Fractures?

If you have diabetes, you probably already know that you have to worry about many potential problems with different body organs–your eyes, your kidneys, your heart. But there is another connection to worry about: your bones. Compared to individuals without diabetes, both men and women with diabetes have a higher risk of fractures, particularly at the hip, with its consequent significant impact on daily life. And if you are older and have diabetes, studies have demonstrated an elevated risk of not only hip fractures, but also those of the upper arm and foot. Women with type 1 diabetes ( the diabetes that results from the loss of insulin production from the pancreas) are approximately 12-fold more likely to have a fracture than women without diabetes, according to data from the Iowa Women’s Health Study. The reasons for why those who have diabetes mellitus have an increased risk for osteoporosis and bone fractures are not entirely clear at this time. This article will discuss some of the potential causes for this associated increased risk and will make some suggestions for prevention of osteoporosis and bone fractures. There have been several large studies that have shown that individuals with either type 1 diabetes or type 2 ( the diabetes that results from insulin not working as it should, compounded by progressive loss of the body’s ability to make insulin) have increased risk of bone fractures and osteoporosis. The link between fractures and diabetes seems to be stronger if you have type 1 diabetes than if you have type 2 diabetes. Type 1 diabetes is associated with decreased bone mass and although data for bone mass in type 2 diabetes may or may not be decreased, there is evidence of altered bone quality. The potential causes could be directly from glucose (blo Continue reading >>

Diabetes And Osteoporosis

Diabetes And Osteoporosis

With World Diabetes Day on November 14, this is an ideal time to take a look at what osteoporosis and diabetes have in common. Its a lot more than you may realize! High blood sugar and high insulin levels damage bone Scientists are untangling a multitude of ways in which high blood sugar and high insulin levels damage bone, including: Suppressing bone turnover. Insulin has been known to contribute to the bone remodeling process for a number of years (Rosen & Motyl, 2010). But when insulin is present in excessive amounts (as in type 2 diabetes), bone resorption and circulating levels of osteocalcin both decrease within hours of an insulin surge, according to a recent study (Ivaska et al., 2015). Increasing inflammation. Hyperglycemia has been found to increase oxidative stress, which in turn promotes inflammation throughout the body (Fiorentino et al., 2015). Weaknesses in collagen that occur when blood sugar is chronically high. This means that bone in someone with diabetes (regardless of type) is more fragile than would be expected for a given bone density, putting them at greater fracture risk. One recent symposium of international scientists even called for recognition of diabetic osteodystrophy given how well-known the connection between diabetes and poor bone health has become (Epstein et al., 2016). Diabetes dramatically increases fracture risk Even though folks with diabetes often have higher bone densities then their non-diabetic peers, they fracture much more. A recent systemic review of 16 studies confirms that those with type 2 diabetes have nearly 3 times the risk of hip fracture as age-matched non-diabetics. Persons with type 1 diabetes fare even worse, having more than a 6-fold increased risk of hip fracture as they age. 3 steps to manage blood sugar and Continue reading >>

Impact Of Diabetes And Diabetes Medications On Bone Health | Endocrine Reviews | Oxford Academic

Impact Of Diabetes And Diabetes Medications On Bone Health | Endocrine Reviews | Oxford Academic

Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fractures despite increased body weight and normal or higher bone mineral density. The mechanisms by which T2DM increases skeletal fragility are unclear. It is likely that a combination of factors, including a greater risk of falling, regional osteopenia, and impaired bone quality, contributes to the increased fracture risk. Drugs for the treatment of T2DM may also impact on the risk for fractures. For example, thiazolidinediones accelerate bone loss and increase the risk of fractures, particularly in older women. In contrast, metformin and sulfonylureas do not appear to have a negative effect on bone health and may, in fact, protect against fragility fracture. Animal models indicate a potential role for incretin hormones in bone metabolism, but there are only limited data on the impact of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists on bone health in humans. Animal models also have demonstrated a role for amylin in bone metabolism, but clinical trials in patients with type 1 diabetes with an amylin analog (pramlintide) have not shown a significant impact on bone metabolism. The effects of insulin treatment on fracture risk are inconsistent with some studies showing an increased risk and others showing no effect. Finally, although there is limited information on the latest class of medications for the treatment of T2DM, the sodium-glucose co-transporter-2 inhibitors, these drugs do not seem to increase fracture risk. Because diabetes is an increasingly common chronic condition that can affect patients for many decades, further research into the effects of agents for the treatment of T2DM on bone metabolism is warranted. In this review, the physiological mechanism Continue reading >>

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