Osteoporosis and bone fractures risk: Role of type 1 and type 2 diabetes

Osteoporosis is a disease that affects the bones. Individuals with osteoporosis experience bone density loss, making bones more fragile and prone to fractures. Osteoporosis typically affects women more than men, but being female isn’t the only risk factor.

Other risk factors for osteoporosis include being older in age, being Caucasian or Asian, bone structure, body weight, family history, history of broken bones, cigarette smoking, caffeine consumption, certain diseases and medications. However, two risk factors often overlooked are type 1 and type 2 diabetes.

Type 1 diabetes and osteoporosis

The link between type 1 diabetes and osteoporosis was uncovered over a decade ago, but has lately been gaining more attention. Type 1 diabetes is associated with low bone density – a characteristic of osteoporosis as well. A study from Norway uncovered that women with type 1 diabetes had higher cases of hip fractures than nondiabetic females.

An alternative study revealed that the duration of diabetes also plays a role in bone health. They found that even women who had type 1 diabetes for less than five years had a 12.25 increase in bone fractures when compared with non-diabetic women.

Researchers aren’t certain as to why type 1 diabetes contributes to bone loss but theories are based on animal and cellular models. Some factors, including diabetic neuropathy, diabetic cataracts and diabetic retinopathy, have all been associated with an increase in bone fractures.

Type 1 diabetes typically occurs in younger individuals – during a time when much bone formation occurs. Researchers believe that low bone mass is a direct complication of type 1 diabetes.

Type 2 diabetes and osteoporosis

Previous research revealed that type 2 diabetes could actually protect the bones as added body weight can make them stronger. But recent findings suggest otherwise.

Individuals with type 2 diabetes are at an increased risk of bone fractures due to peripheral neuropathy, possible hypoglycemia, nocturia and visual impairment. Furthermore, those with type 2 diabetes are typically overweight and live a primarily sedentary life, which can affect balance and coordination. Overall, individuals with higher body weight and high bone mass have an increased risk of fractures.

Additionally, one study revealed that women with type 2 diabetes were more likely to have bone fractures of the hips, humerus and foot than women who were not diabetic. Furthermore, bone loss has been shown to be more significant in individuals who do not have their diabetes well managed.

Diabetes and increased bone fracture risk

As you can tell, both types 1 and 2 diabetes play a role as risk factors for osteoporosis, and much research suggests it can increase the risk of bone fractures. In type 1 diabetics it has been shown that bone density is reduced primarily in the hip and spine. This increases the risk of fractures in both of those areas.

In type 2 diabetics bone density is higher in the femoral neck and lumbar spine, but bone fractures occur in the hips.

Diabetic bone is often noted to be more fragile than nondiabetic bone, thus contributing to a higher risk of fractures. Because of this, even osteoporosis treatments may not be as effective in diabetics because diabetes has its own bone complications. Furthermore, diabetes increases the likelihood of experiencing falls due to many of its other complications, which further increase the risk of fractures.

Prevent and treat osteoporosis in people with diabetes

As mentioned, osteoporosis treatment may become compromised in individuals with diabetes. It’s important to try and prevent both osteoporosis and diabetes (type 2 that is) as best as possible to avoid complications and reduce the risk of bone fractures.

The good news is that many of the prevention and management tips of osteoporosis are the same for type 2 diabetes – the key is overall healthy living. Here are the lifestyle changes you need to make to manage osteoporosis and diabetes – and prevent it if you aren’t diagnosed.

• Consume a diet rich in calcium and get adequate sunlight to boost vitamin D.
• Exercise – not only does it help you lose weight (a risk factor for diabetes), but it increases bone and muscle strength and improves coordination.
• Don’t smoke and minimize alcohol consumption.
• Get a bone density test.

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Sources:
http://www.webmd.com/osteoporosis/guide/osteoporosis-risk-factors
http://www.endocrineweb.com/professional/meetings/analysis-increased-risk-fracture-diabetes
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/diabetes
http://clinical.diabetesjournals.org/content