This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- Individuals with sort 1 and sort 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 to get sufficient calcium and vitamin D, specifically.
- Different methods to scale back osteoporosis threat embrace partaking in common power coaching and receiving really helpful screenings, and maintaining with blood sugar administration.
Until you’ve just lately damaged one thing, bone well being might not be prime of thoughts. However retaining bones wholesome is crucial, particularly for folks with diabetes, who could also be at greater threat for osteoporosis.
Even if you happen to’ve already been recognized with osteoporosis, it’s by no means too late to start out constructing sturdy bones and forestall 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 turn out to be weak and brittle. This will increase the danger of bone fractures from even minor stresses, akin to falling from a standing place and even from coughing, Kazlauskaite stated.
Like your pores and skin, bone resides tissue that’s frequently re-growing. Osteoporosis occurs when outdated bone is misplaced quicker than new bone might be created. Usually, folks with osteoporosis don’t discover any signs within the early phases – you’ll be able to’t really feel your bones getting smaller and thinner. In later phases, chances are you’ll 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 shortly 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 various issues and infections, which can take longer to heal with diabetes.
Diabetes-related issues like neuropathy and imaginative and prescient issues can even improve the danger of fractures, Kazlauskaite stated. As an example, peripheral neuropathy can cut back foot power, which may result in severe falls. Likewise, if you happen to can’t see correctly, chances are you’ll be extra more likely to journey and fall.
Danger components for osteoporosis
Whereas diabetes doesn’t trigger osteoporosis, it will probably increase the danger of growing it. Having diabetes (sort 1 or sort 2) additionally will increase the danger of fractures. In sort 1 diabetes, folks are inclined to have low bone mineral density and will have impaired bone formation, each of which may contribute to osteoporosis.
Different threat components embrace:
- Growing old: Bone development slows as we age and bone loss occurs quicker, rising the danger for bone illness.
- Organic intercourse: Ladies typically are at greater threat for osteoporosis as they have a tendency to have smaller, much less dense bones than males.
- Ethnicity: White and Asian ladies ages 50 and older have an elevated threat of osteoporosis as a consequence of decrease bone density.
- Hormonal modifications: Ladies who’ve gone by way of menopause are at greater threat of osteoporosis as a consequence of a drop in estrogen ranges (low estrogen can cut back bone density. Low testosterone can even improve the danger since testosterone performs a task in retaining bones sturdy.
- Low physique weight: Individuals who weigh lower than 125 kilos have a larger threat of osteoporosis.
- Different situations: Kidney failure, liver illness, inflammatory bowel illness, arthritis, and consuming problems may contribute to the event of osteoporosis.
- Medicines: Some medication influence calcium absorption and bone formation, probably rising the danger of osteoporosis. This consists of diabetes drugs 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 might have osteoporosis or are attempting to stop it, there are many steps you’ll be able to take to take care of bone well being long-term.
1. Preserve a wholesome physique weight
Weight administration is a vital facet of osteoporosis prevention. Being underweight or residing with weight problems can improve the danger of thinning bones and fractures.
Usually, folks with smaller frames have a larger threat of osteoporosis as they have a tendency to have much less bone mass. Their bones are additionally extra more likely to turn out to be fragile with age, Kazlauskaite stated.
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 by way of bariatric surgical procedure – reduces bone mass, which may improve the danger of osteoporosis.
2. Observe power coaching
Whereas power coaching (additionally referred to as resistance coaching) is broadly seen as a solution to construct muscle, it will probably additionally assist keep wholesome bones and cut back fracture threat.
Any type of weight-bearing train – strolling, working, 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 examine discovered that resistance coaching elevated bone mineral density in ladies who had gone by way of menopause. Power workouts like weight lifting additionally enhance posture and steadiness, which will help forestall falls. When you 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 footwear 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 akin to Charcot foot could also be associated to fractures which have gone unnoticed. When you’re unable to train as a consequence of accidents, Kazlauskaite really helpful packages akin to Osteostrong.
3. Eat a calcium-rich eating regimen
Bear in mind being instructed 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 type bones and hold them sturdy. Good sources of calcium embrace milk, cheese, yogurt, seeds, beans and lentils, leafy greens, and fish.
Kazlauskaite really helpful monitoring your calcium consumption by way of an app like My Health Pal or MyNetDiary. Ideally, it is best to devour not less than 1,000 mg of calcium per day, she stated. Individuals who have gone by way of menopause might have greater calcium wants (round 1,200 mg per day).
When you’re not capable of get sufficient calcium by way of your eating regimen, dietary supplements will help. Most individuals begin with calcium citrate, however chances are you’ll wish to take into account calcium phosphate if you happen to expertise unintended effects from calcium citrate, Kazlauskaite suggested.
4. Get sufficient vitamin D
Vitamin D can also be necessary for sturdy bones because it helps your physique take up calcium. Good sources of vitamin D embrace 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 already know the place issues stand. For osteoporosis prevention, vitamin D ranges needs to be not less than 30 ng/mL. Over-the-counter vitamin D dietary supplements can be found at most drugstores and grocery shops.
If for any cause your healthcare supplier isn’t capable of supply 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 normally really helpful for ladies after they enter menopause and for males round age 50, in line with the American Diabetes Affiliation.
As a result of greater probability of fractures, folks with diabetes should be examined for bone fracture threat, Kazlauskaite stated. This consists of the FRAX threat calculator, testing for falls, and analysis with laboratory assessments 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 embrace trabecular bone rating (TBS), Kazlauskaite famous.
Remedy for osteoporosis
When you’ve been recognized with osteoporosis, therapy might contain drugs and life-style modifications. Widespread drugs to deal with osteoporosis are bisphosphonates like alendronate. One other therapy is denosumab, an injection given each six months. Apparently, new analysis reveals alendronate and denosumab might cut back the danger of growing sort 2 diabetes.
Hormone remedy could also be really helpful for ladies who’ve gone by way of menopause or folks with low testosterone. As with osteoporosis prevention, an necessary a part of therapy is retaining bones sturdy 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 occupied with osteoporosis and taking steps to strengthen your bones. Managing your diabetes by way of wholesome life-style modifications and retaining blood glucose ranges in goal vary can go a great distance towards lowering your threat of issues, together with osteoporosis.
