August 15, 2013

Fragile Bones in Diabetes


bones2Diabetes, T1D and T2D, takes a toll on the body. A study looks closer at the toll it takes on bone strength and how to correct this weakening. The study published in Aging Clinical and Experimental Research examines how this risk can be minimized.

A dubious distinction of diabetes is that it can deplete bone mineral density and bone tissue, increasing the risk of broken bones. As if that’s not bad enough, this also reduces bone quality and strength, but these are not considerations in bone mineral density but weighing greatly on bone fragility.

The reason for increased rate of broken bones in people with diabetes is due to a long duration of diabetes coupled with microvascular complications. In turn, this can lead to a greater risk of falling.

This is the perfect place to inject my personal experience with the aforementioned higher incidence of falling leading to a broken bone. Case in point, I fractured my ankle on May 2. I didn’t know it was broken until May 20. Six weeks later, it wasn’t healed. I had surgery and now I’m wearing an external fixator for 4 months. Thanks mom.

Turns-out that diabetes leads to impaired bone formation because of insulin deficiency and elevated blood glucose,, insulin growth factor reduction, and deficiency in bone signaling pathways. No kidding.

So now what? Being held captive in “non weight baring” status for 4 months does me no good. This study finds that metformin, incretins, and DPP-4 inhibitors like Januvia or Onglyza have a potentially positive effect on bone strength,.

For those people treating diabetes with thiazolidinediones, like Actos or Avandia, be aware that they are associated with an increased risk of fracture. It’s an FYI, not a message to overrule your doctor. But bring it to his or her attention on your next visit.

Visit Your Diabetes Health for more resources about health.