This content material initially appeared on diaTribe. Republished with permission.
By April Hopcroft
Key takeaways:
- Individuals with kind 1 and kind 2 diabetes have an elevated danger of creating osteoporosis and experiencing bone fractures.
- Sustaining a wholesome physique weight and consuming a nutritious eating regimen are key to wholesome bones – you’ll want to get sufficient calcium and vitamin D, particularly.
- Different methods to scale back osteoporosis danger embody partaking in common energy coaching and receiving beneficial screenings, and maintaining with blood sugar administration.
Until you’ve just lately damaged one thing, bone well being will not be prime of thoughts. However protecting bones wholesome is essential, particularly for folks with diabetes, who could also be at increased danger for osteoporosis.
Even in case 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 know the connection between bone illness and diabetes.
What’s osteoporosis?
Osteoporosis is a situation that causes bones to change into weak and brittle. This will increase the danger of bone fractures from even minor stresses, corresponding to falling from a standing place and even from coughing, Kazlauskaite mentioned.
Like your pores and skin, bone resides tissue that’s frequently re-growing. Osteoporosis occurs when outdated bone is misplaced sooner than new bone may be created. Typically, folks with osteoporosis don’t discover any signs within the early levels – you possibly can’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 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 intervals 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 may also enhance the danger of fractures, Kazlauskaite mentioned. For example, peripheral neuropathy can scale back foot energy, which might result in critical falls. Likewise, in case you can’t see correctly, chances are you’ll be extra more likely to journey and fall.
Danger elements for osteoporosis
Whereas diabetes doesn’t trigger osteoporosis, it might increase the danger of creating it. Having diabetes (kind 1 or kind 2) additionally will increase the danger of fractures. In kind 1 diabetes, folks are likely to have low bone mineral density and should have impaired bone formation, each of which might contribute to osteoporosis.
Different danger elements embody:
- Growing old: Bone progress slows as we age and bone loss occurs sooner, growing the danger for bone illness.
- Organic intercourse: Girls typically are at increased danger for osteoporosis as they have a tendency to have smaller, much less dense bones than males.
- Ethnicity: White and Asian girls ages 50 and older have an elevated danger of osteoporosis attributable to decrease bone density.
- Hormonal modifications: Girls who’ve gone by means of menopause are at increased danger of osteoporosis attributable to a drop in estrogen ranges (low estrogen can scale back bone density. Low testosterone may also enhance the danger since testosterone performs a task in protecting bones robust.
- Low physique weight: Individuals who weigh lower than 125 kilos have a better danger of osteoporosis.
- Different circumstances: Kidney failure, liver illness, inflammatory bowel illness, arthritis, and consuming issues might contribute to the event of osteoporosis.
- Drugs: Some medicine influence calcium absorption and bone formation, probably growing the danger of osteoporosis. This contains diabetes medicines like sulfonylureas, thiazolidinediones, and SGLT-2 inhibitors, in addition to diuretics (water drugs), that are used to handle kidney and heart problems.
5 methods to strengthen bones
Whether or not you could 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 crucial side of osteoporosis prevention. Being underweight or residing with weight problems can enhance the danger of thinning bones and fractures.
Usually, folks with smaller frames have a better danger of osteoporosis as they have a tendency to have much less bone mass. Their bones are additionally extra more likely to change into fragile with age, Kazlauskaite mentioned.
In the meantime, weight problems can enhance the danger of fractures, particularly on the tibia (shinbone), humerus (higher arm), and ankle. Weight reduction – particularly fast weight reduction by means of bariatric surgical procedure – reduces bone mass, which might enhance the danger of osteoporosis.
2. Apply energy coaching
Whereas energy coaching (additionally referred to as resistance coaching) is broadly considered as a method to construct muscle, it might additionally assist preserve wholesome bones and scale back fracture danger.
Any kind of weight-bearing train – strolling, working, dancing, and even pickleball – will put drive 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 girls who had gone by means of menopause. Energy workouts like weight lifting additionally enhance posture and steadiness, which can assist stop 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 sneakers for any bodily exercise, Kazlauskaite mentioned, as folks with diabetes are at an particularly excessive danger of fractures within the ankle and tibia. Diabetes-related foot issues corresponding to Charcot foot could also be associated to fractures which have gone unnoticed. When you’re unable to train attributable to accidents, Kazlauskaite beneficial applications corresponding to Osteostrong.
3. Eat a calcium-rich eating regimen
Keep in mind being instructed as a child to complete your milk as a result of it builds robust bones? That’s as a result of milk incorporates calcium, a mineral that helps type bones and hold them robust. Good sources of calcium embody milk, cheese, yogurt, seeds, beans and lentils, leafy greens, and fish.
Kazlauskaite beneficial monitoring your calcium consumption by means of an app like My Health Pal or MyNetDiary. Ideally, you must eat a minimum of 1,000 mg of calcium per day, she mentioned. Individuals who have gone by means of menopause might have increased calcium wants (round 1,200 mg per day).
When you’re not capable of get sufficient calcium by means of your eating regimen, dietary supplements can assist. Most individuals begin with calcium citrate, however chances are you’ll wish to take into account calcium phosphate in case you expertise uncomfortable side effects from calcium citrate, Kazlauskaite suggested.
4. Get sufficient vitamin D
Vitamin D can also be vital for robust 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 needs to be a minimum of 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 capable of provide vitamin D testing, Kazlauskaite prompt 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 beneficial for ladies after they enter menopause and for males round age 50, in accordance with the American Diabetes Affiliation.
As a result of increased probability of fractures, folks with diabetes have to be examined for bone fracture danger, Kazlauskaite mentioned. This contains the FRAX danger calculator, testing for falls, and analysis with laboratory assessments and a bone density (DXA) scan.
For folks with kind 1 diabetes, DXA scans are beneficial on the time of analysis and each 2-5 years. The bone density testing should embody trabecular bone rating (TBS), Kazlauskaite famous.
Therapy for osteoporosis
When you’ve been recognized 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. Apparently, new analysis reveals alendronate and denosumab might scale back the danger of creating kind 2 diabetes.
Hormone remedy could also be beneficial for ladies who’ve gone by means of menopause or folks with low testosterone. As with osteoporosis prevention, an vital a part of therapy is protecting bones robust 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 start out eager about osteoporosis and taking steps to strengthen your bones. Managing your diabetes by means of wholesome way of life modifications and protecting blood glucose ranges in goal vary can go a good distance towards lowering your danger of issues, together with osteoporosis.
