This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- Folks with sort 1 and sort 2 diabetes have an elevated danger of growing osteoporosis and experiencing bone fractures.
- Sustaining a wholesome physique weight and consuming a nutritious weight loss program are key to wholesome bones – you’ll want to get sufficient calcium and vitamin D, specifically.
- Different methods to cut back osteoporosis danger embody participating in common power coaching and receiving advisable screenings, and maintaining with blood sugar administration.
Except you’ve just lately damaged one thing, bone well being will not be prime of thoughts. However holding bones wholesome is essential, particularly for individuals with diabetes, who could also be at greater danger for osteoporosis.
Even in the event you’ve already been recognized with osteoporosis, it’s by no means too late to start out constructing robust bones and stop breaks. We spoke to Dr. Rasa Kazlauskaite, an endocrinologist with intensive 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 danger of bone fractures from even minor stresses, reminiscent of falling from a standing place and even from coughing, Kazlauskaite mentioned.
Like your pores and skin, bone resides tissue that’s regularly re-growing. Osteoporosis occurs when outdated bone is misplaced quicker than new bone may be created. Typically, individuals with osteoporosis don’t discover any signs within the early levels – you’ll be able to’t really feel your bones getting smaller and thinner. In later levels, chances are you’ll discover lack of peak, stooped posture, or damaged bones (generally within the backbone, hip, or wrist). Typically the primary signal of osteoporosis is a fractured bone.
“We hear all about coronary heart assault prevention, however we don’t hear about fracture danger,” Kazlauskaite mentioned.
Whereas many can individuals heal rapidly from a break with out problems, bone fractures could require a long-term want for crutches, a wheelchair, or a walker – particularly in older adults. Lengthy intervals of being motionless can result in many various problems and infections, which can take longer to heal with diabetes.
Diabetes-related problems like neuropathy and imaginative and prescient issues can even improve the danger of fractures, Kazlauskaite mentioned. As an example, peripheral neuropathy can scale back foot power, which might result in severe falls. Likewise, in the event you can’t see correctly, chances are you’ll be extra more likely to journey and fall.
Threat components for osteoporosis
Whereas diabetes doesn’t trigger osteoporosis, it could elevate the danger of growing it. Having diabetes (sort 1 or sort 2) additionally will increase the danger of fractures. In sort 1 diabetes, individuals are likely to have low bone mineral density and should have impaired bone formation, each of which might contribute to osteoporosis.
Different danger components embody:
- Getting older: Bone development slows as we age and bone loss occurs quicker, rising the danger for bone illness.
- Organic intercourse: Girls typically are at greater danger 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 danger of osteoporosis as a result of decrease bone density.
- Hormonal adjustments: Girls who’ve gone via menopause are at greater danger of osteoporosis as a result of a drop in estrogen ranges (low estrogen can scale back bone density. Low testosterone can even improve the danger since testosterone performs a job in holding bones robust.
- Low physique weight: Individuals who weigh lower than 125 kilos have a larger danger of osteoporosis.
- Different situations: Kidney failure, liver illness, inflammatory bowel illness, arthritis, and consuming problems might contribute to the event of osteoporosis.
- Drugs: Some medication impression calcium absorption and bone formation, probably rising the danger of osteoporosis. This consists of diabetes medicines like sulfonylureas, thiazolidinediones, and SGLT-2 inhibitors, in addition to diuretics (water capsules), that are used to handle kidney and heart problems.
5 methods to strengthen bones
Whether or not you could have osteoporosis or are attempting to stop it, there are many steps you’ll be able to take to keep up bone well being long-term.
1. Preserve a wholesome physique weight
Weight administration is a crucial side of osteoporosis prevention. Being underweight or dwelling with weight problems can improve the danger of thinning bones and fractures.
Typically, individuals with smaller frames have a larger danger 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 mentioned.
In the meantime, weight problems can improve the danger of fractures, particularly on the tibia (shinbone), humerus (higher arm), and ankle. Weight reduction – particularly fast weight reduction via bariatric surgical procedure – reduces bone mass, which might improve the danger of osteoporosis.
2. Apply power coaching
Whereas power coaching (additionally known as resistance coaching) is broadly seen as a solution to construct muscle, it could additionally assist preserve wholesome bones and scale back fracture danger.
Any type of weight-bearing train – strolling, working, dancing, and even pickleball – will put pressure in your bones and assist strengthen them. Weight-bearing workout routines assist stimulate bones to resume themselves, Kazlauskaite defined.
A 2022 examine discovered that resistance coaching elevated bone mineral density in girls who had gone via menopause. Power workout routines like weight lifting additionally enhance posture and steadiness, which can assist forestall falls. If you happen to use free weights or weight machines, it’s a good suggestion to start out small and construct up slowly.
Be sure you put on correct sneakers for any bodily exercise, Kazlauskaite mentioned, as individuals with diabetes are at an particularly excessive danger of fractures within the ankle and tibia. Diabetes-related foot problems reminiscent of Charcot foot could also be associated to fractures which have gone unnoticed. If you happen to’re unable to train as a result of accidents, Kazlauskaite advisable packages reminiscent of Osteostrong.
3. Eat a calcium-rich weight loss program
Bear in mind being informed as a child to complete your milk as a result of it builds robust bones? That’s as a result of milk comprises calcium, a mineral that helps kind bones and preserve them robust. Good sources of calcium embody milk, cheese, yogurt, seeds, beans and lentils, leafy greens, and fish.
Kazlauskaite advisable monitoring your calcium consumption via an app like My Health Pal or MyNetDiary. Ideally, you need to eat at the least 1,000 mg of calcium per day, she mentioned. Individuals who have gone via menopause could have greater calcium wants (round 1,200 mg per day).
If you happen to’re not in a position to get sufficient calcium via your weight loss program, dietary supplements can assist. Most individuals begin with calcium citrate, however chances are you’ll wish to think about calcium phosphate in the event you expertise unintended effects from calcium citrate, Kazlauskaite suggested.
4. Get sufficient vitamin D
Vitamin D can also be necessary for robust bones because it helps your physique take in 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.
In case you are taking vitamin D dietary supplements, Kazlauskaite recommends getting your ranges checked so you realize the place issues stand. For osteoporosis prevention, vitamin D ranges must be at the least 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 steered the web site walkinlab.com, which lets you join low-cost testing by yourself.
5. Get screened for osteoporosis
For individuals with diabetes, bone mineral density scans are often advisable for girls after they enter menopause and for males round age 50, in response to the American Diabetes Affiliation.
As a result of greater probability of fractures, individuals with diabetes must be examined for bone fracture danger, Kazlauskaite mentioned. This consists of the FRAX danger calculator, testing for falls, and analysis with laboratory assessments and a bone density (DXA) scan.
For individuals with sort 1 diabetes, DXA scans are advisable on the time of prognosis and each 2-5 years. The bone density testing should embody trabecular bone rating (TBS), Kazlauskaite famous.
Therapy for osteoporosis
If you happen to’ve been recognized with osteoporosis, remedy could contain medicines and life-style adjustments. Widespread medicines to deal with osteoporosis are bisphosphonates like alendronate. One other remedy is denosumab, an injection given each six months. Apparently, new analysis exhibits alendronate and denosumab could scale back the danger of growing sort 2 diabetes.
Hormone remedy could also be advisable for girls who’ve gone via menopause or individuals with low testosterone. As with osteoporosis prevention, an necessary a part of remedy is holding bones robust and wholesome – this consists of getting common train, consuming nutritiously, and sustaining a wholesome weight.
The underside line
It’s by no means too early to start out fascinated with osteoporosis and taking steps to strengthen your bones. Managing your diabetes via wholesome life-style adjustments and holding blood glucose ranges in goal vary can go a great distance towards lowering your danger of problems, together with osteoporosis.
