How Does Diabetes Affect Bone Health?  

Diabetes and bone health are generally things people don’t associate together. However, numerous studies in the recent decades have revealed that diabetes and bone health are intricately related.¹ Both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) affect bone health through various mechanisms. Studies show that both T1DM and T2DM are associated with increased risk of low-trauma fractures, especially higher rates of hip fractures than the general population.^2–4

Why Does Diabetes Affect Bone Health?

Research indicates that the diabetic environment causes molecular and structural changes that affect bone strength, bone mineral density, bone turnover, and bone structure.¹ It is thought that these changes ultimately result in increased fragility, increased fracture risk, and impaired bone healing.² However, the way T1DM and T2DM affects bone health seem to differ. For instance, T1DM may impair skeletal growth from lack of insulin as well as other growth factors at a young age, which can affect long-term bone health. On the other hand, T2DM, which usually develops later in life, can affect bone health primarily through chronic exposure to a hyperglycemic environment. Additionally, microvascular complications associated with diabetes can impair bone healing as well as increase the risk of falls that lead to fractures.

What Are Ways to Protect Bone Health?

As is with other diabetes-related complications, the best way to protect bone health is by keeping diabetes under control.² Maintaining a healthy lifestyle through healthy eating and regular exercises is crucial to achieving target blood glucose levels, hemoglobin A1C levels, and weight loss goals which can keep diabetes under control. Focusing on strength-building exercises can help improve glycemic control as well as with reducing the risk of falls.⁵ Consuming adequate amounts of calcium through diet can also be key, in addition to considering vitamin D supplementation.