This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- Individuals with sort 1 and kind 2 diabetes have an elevated threat of growing osteoporosis and experiencing bone fractures.
- Sustaining a wholesome physique weight and consuming a nutritious eating regimen are key to wholesome bones – make sure you get sufficient calcium and vitamin D, particularly.
- Different methods to scale back osteoporosis threat embody participating in common power coaching and receiving really helpful screenings, and maintaining with blood sugar administration.
Until you’ve lately damaged one thing, bone well being might not be prime of thoughts. However protecting bones wholesome is important, particularly for folks with diabetes, who could also be at larger threat for osteoporosis.
Even in the event you’ve already been identified with osteoporosis, it’s by no means too late to begin constructing sturdy bones and stop breaks. We spoke to Dr. Rasa Kazlauskaite, an endocrinologist with in depth expertise in osteoporosis, to grasp the connection between bone illness and diabetes.
What’s osteoporosis?
Osteoporosis is a situation that causes bones to develop into weak and brittle. This will increase the chance of bone fractures from even minor stresses, comparable to falling from a standing place and even from coughing, Kazlauskaite stated.
Like your pores and skin, bone resides tissue that’s regularly re-growing. Osteoporosis occurs when previous bone is misplaced sooner than new bone might be created. Usually, folks with osteoporosis don’t discover any signs within the early phases – you possibly can’t really feel your bones getting smaller and thinner. In later phases, you could discover lack of top, stooped posture, or damaged bones (generally within the backbone, hip, or wrist). Usually the primary signal of osteoporosis is a fractured bone.
“We hear all about coronary heart assault prevention, however we don’t hear about fracture threat,” Kazlauskaite stated.
Whereas many can folks heal rapidly from a break with out issues, bone fractures might require a long-term want for crutches, a wheelchair, or a walker – particularly in older adults. Lengthy durations of being motionless can result in many alternative issues and infections, which can take longer to heal with diabetes.
Diabetes-related issues like neuropathy and imaginative and prescient issues also can improve the chance of fractures, Kazlauskaite stated. For example, peripheral neuropathy can scale back foot power, which may result in critical falls. Likewise, in the event you can’t see correctly, you could be extra more likely to journey and fall.
Threat components for osteoporosis
Whereas diabetes doesn’t trigger osteoporosis, it will possibly elevate the chance of growing it. Having diabetes (sort 1 or sort 2) additionally will increase the chance of fractures. In sort 1 diabetes, folks are inclined to have low bone mineral density and will have impaired bone formation, each of which might contribute to osteoporosis.
Different threat components embody:
- Growing older: Bone development slows as we age and bone loss occurs sooner, rising the chance for bone illness.
- Organic intercourse: Girls usually are at larger threat for osteoporosis as they have an inclination to have smaller, much less dense bones than males.
- Ethnicity: White and Asian girls ages 50 and older have an elevated threat of osteoporosis on account of decrease bone density.
- Hormonal modifications: Girls who’ve gone by menopause are at larger threat of osteoporosis on account of a drop in estrogen ranges (low estrogen can scale back bone density. Low testosterone also can improve the chance since testosterone performs a task in protecting bones sturdy.
- Low physique weight: Individuals who weigh lower than 125 kilos have a higher threat of osteoporosis.
- Different circumstances: Kidney failure, liver illness, inflammatory bowel illness, arthritis, and consuming issues may contribute to the event of osteoporosis.
- Drugs: Some medication influence calcium absorption and bone formation, probably rising the chance of osteoporosis. This contains diabetes medicines like sulfonylureas, thiazolidinediones, and SGLT-2 inhibitors, in addition to diuretics (water tablets), that are used to handle kidney and heart problems.
5 methods to strengthen bones
Whether or not you may have osteoporosis or try to stop it, there are many steps you possibly can take to keep up bone well being long-term.
1. Keep a wholesome physique weight
Weight administration is a vital facet of osteoporosis prevention. Being underweight or residing with weight problems can improve the chance of thinning bones and fractures.
Usually, folks with smaller frames have a higher threat of osteoporosis as they have an inclination to have much less bone mass. Their bones are additionally extra more likely to develop into fragile with age, Kazlauskaite stated.
In the meantime, weight problems can improve the chance of fractures, particularly on the tibia (shinbone), humerus (higher arm), and ankle. Weight reduction – particularly fast weight reduction by bariatric surgical procedure – reduces bone mass, which might improve the chance of osteoporosis.
2. Apply power coaching
Whereas power coaching (additionally referred to as resistance coaching) is extensively seen as a technique to construct muscle, it will possibly additionally assist preserve wholesome bones and scale back fracture threat.
Any form of weight-bearing train – strolling, operating, dancing, and even pickleball – will put power in your bones and assist strengthen them. Weight-bearing workouts assist stimulate bones to resume themselves, Kazlauskaite defined.
A 2022 research discovered that resistance coaching elevated bone mineral density in girls who had gone by menopause. Power workouts like weight lifting additionally enhance posture and stability, which may also help stop falls. When you use free weights or weight machines, it’s a good suggestion to begin small and construct up slowly.
You’ll want to put on correct sneakers for any bodily exercise, Kazlauskaite stated, as folks with diabetes are at an particularly excessive threat of fractures within the ankle and tibia. Diabetes-related foot issues comparable to Charcot foot could also be associated to fractures which have gone unnoticed. When you’re unable to train on account of accidents, Kazlauskaite really helpful applications comparable to Osteostrong.
3. Eat a calcium-rich eating regimen
Bear in mind being advised as a child to complete your milk as a result of it builds sturdy bones? That’s as a result of milk incorporates calcium, a mineral that helps kind bones and hold them sturdy. Good sources of calcium embody milk, cheese, yogurt, seeds, beans and lentils, leafy greens, and fish.
Kazlauskaite really helpful monitoring your calcium consumption by an app like My Health Pal or MyNetDiary. Ideally, you need to eat no less than 1,000 mg of calcium per day, she stated. Individuals who have gone by menopause might have larger calcium wants (round 1,200 mg per day).
When you’re not in a position to get sufficient calcium by your eating regimen, dietary supplements may also help. Most individuals begin with calcium citrate, however you could wish to take into account calcium phosphate in the event you expertise negative effects from calcium citrate, Kazlauskaite suggested.
4. Get sufficient vitamin D
Vitamin D can be vital for sturdy bones because it helps your physique take up calcium. Good sources of vitamin D embody egg yolks, mushrooms, and sure fish like salmon, tuna, and sardines. A number of meals are fortified with vitamin D, together with milk, orange juice, cereal, and oatmeal.
If you’re taking vitamin D dietary supplements, Kazlauskaite recommends getting your ranges checked so you recognize the place issues stand. For osteoporosis prevention, vitamin D ranges ought to be no less than 30 ng/mL. Over-the-counter vitamin D dietary supplements can be found at most drugstores and grocery shops.
If for any purpose your healthcare supplier isn’t in a position to provide vitamin D testing, Kazlauskaite recommended the web site walkinlab.com, which lets you join low-cost testing by yourself.
5. Get screened for osteoporosis
For folks with diabetes, bone mineral density scans are often really helpful for ladies once they enter menopause and for males round age 50, in line with the American Diabetes Affiliation.
Because of the larger likelihood of fractures, folks with diabetes should be examined for bone fracture threat, Kazlauskaite stated. This contains the FRAX threat calculator, testing for falls, and analysis with laboratory checks and a bone density (DXA) scan.
For folks with sort 1 diabetes, DXA scans are really helpful on the time of prognosis and each 2-5 years. The bone density testing should embody trabecular bone rating (TBS), Kazlauskaite famous.
Remedy for osteoporosis
When you’ve been identified with osteoporosis, therapy might contain medicines and way of life modifications. Widespread medicines to deal with osteoporosis are bisphosphonates like alendronate. One other therapy is denosumab, an injection given each six months. Curiously, new analysis exhibits alendronate and denosumab might scale back the chance of growing sort 2 diabetes.
Hormone remedy could also be really helpful for ladies who’ve gone by menopause or folks with low testosterone. As with osteoporosis prevention, an vital a part of therapy is protecting bones sturdy and wholesome – this contains getting common train, consuming nutritiously, and sustaining a wholesome weight.
The underside line
It’s by no means too early to begin desirous about osteoporosis and taking steps to strengthen your bones. Managing your diabetes by wholesome way of life modifications and protecting blood glucose ranges in goal vary can go a good distance towards lowering your threat of issues, together with osteoporosis.
