Osteoporosis and diabetes are two distinct conditions – but sometimes they can occur together and this turn of events can have significant implications for the health and well-being of affected individuals. The two conditions when experienced together, present a complex relationship, and therefore understanding how to manage them in tandem is vital.
The impact of osteoporosis on diabetes
Osteoporosis is a condition characterised by a decrease in bone density, which leads to bones becoming increasingly brittle and more prone to fractures. While osteoporosis primarily affects the skeletal system, its impact on diabetes can be both direct and indirect.
Increased risk of falls: Osteoporosis can lead to bone fractures, especially in the hip and spine, which in turn may result in reduced mobility and increasing the risk of falls. When diabetes is added to the mix, these falls can have serious consequences, as they may lead to complications such as foot ulcers and impaired wound healing.
Impaired mobility: Osteoporosis-related fractures can limit an individual’s ability to exercise and maintain physical activity – and as physical activity is crucial for diabetes management, this becomes problematic as exercise is beneficial in controlling blood sugar levels in the diabetic patient.
Chronic pain: In addition, osteoporosis-related fractures can cause chronic pain, which may contribute to reduced quality of life and increased stress. Stress can, in turn, impact blood glucose levels in individuals with diabetes, potentially making glycemic control more challenging.
Medications: Some medications that are used to treat osteoporosis, like glucocorticoids, can negatively affect blood glucose levels and contribute to the development or worsening of diabetes. It is important for individuals with both conditions to work closely with their healthcare providers to monitor and manage potential medication-related interactions.
Nutrition: Because osteoporosis management often involves increasing calcium and vitamin D intake, greater care must be taken in managing the dietary needs of the diabetic patient. Both conditions need a balance of diet and supplements that will contribute to maintaining the most effective approach to both diseases.
The impact of diabetes on osteoporosis
Poor glycemic control: High blood sugar levels – the key signature of diabetes – can impair the body’s ability to build and repair bone tissue. Chronic hyperglycemia can lead to the release of advanced glycation end products (AGEs), which in turn can weaken bones and reduce bone density.
Hormonal imbalance: Diabetes can disrupt the balance of hormones that in turn affect bone health, such as insulin, insulin-like growth factor-1 (IGF-1), and parathyroid hormone (PTH). These hormonal imbalances can negatively affect bone formation and resorption.
Obesity and bone health: Many individuals with Type II diabetes are overweight or obese. Obesity-related insulin resistance and inflammation can indirectly impact bone health by altering the hormonal environment. In addition to weakening the bones, the weight itself can further negatively impact the bones by stressing the bone structure and causing a variety of complications.
Medications: Some medications that are commonly used to manage diabetes, such as thiazolidinediones, have been associated with an increased risk of bone fractures. Balancing the management of diabetes with the risk of bone loss in a patient who also presents with osteoporosis is a complex process, and essential for healthcare providers to take focused care when prescribing medications.
Preventive measures and management
Nutrition: A well-balanced diet rich in calcium and vitamin D is important for bone health. However, individuals with diabetes should also prioritise glycemic control. Keeping active is also important. Weight-bearing exercises, such as walking and strength training, are beneficial for both bone health and blood sugar control.
Medication: If medications for osteoporosis or diabetes are necessary, you need to discuss potential interactions and side effects with your healthcare team. Regular monitoring and adjustments may be needed to maintain overall health.
Regular checkups: It is important that you have regular checkups if you have diabetes. And bone density tests should be included. This allows for early detection and intervention in cases of osteoporosis – and early detection in turn, is vital to helping to prevent fractures.
Blood sugar control: Strict glycemic control is crucial for diabetes management. If undertaken with focus and regularity, the impact of diabetes on bone health could be minimised.
Fall prevention: Obviously, for those with osteoporosis, fall prevention measures are essential. This may include modifications in the living environment, the use of assistive devices, and balance and strength training.
NOFSA (National Osteoporosis Foundation South Africa)
NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.
Find out more about our work at: www.osteoporosis.org.za