Type 1 and type 2 diabetes can be associated with problems with bone health.

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The major symptoms of diabetes are problems with high and low blood sugar, but how else does diabetes affect the body? The complications and effects of diabetes can be widespread, affecting everything from your heart to your bones. Learn how both type 1 and type 2 diabetes can be associated with problems with bone health.

Type 1 diabetes and risk for osteoporosis

There is a very strong link between type 1 diabetes and poor bone health. One large meta-analysis concluded that the relative risk of hip fracture was almost seven times higher in people with type 1 diabetes compared to people without diabetes. Further, bone mineral density (BMD) was significantly decreased in both the spine and hip for people with type 1 diabetes.[1]

Type 1 diabetes can affect bone strength and health in numerous ways, as the condition affects the formation and breakdown of bone. Insulin deficiency in type 1 diabetes plays a large role in this association because insulin and insulin-like growth factor-1 both lead to decreased bone formation and bone mass.[2] Diabetes also influences vitamin D metabolism, which impairs bone quality.[3]

Studies show that people with diabetes seem to be at a higher risk for vitamin D deficiency, which is important for maintaining healthy bones.[2] Insulin and vitamin D are only a few of several hormones and molecules that help explain the link between type 1 diabetes and increased risk for osteoporosis.

Type 2 diabetes: regular BMD but high fracture risk

Bone mineral density scores tend to be normal in people with type 2 diabetes, yet these people are still at an increased risk of fractures. The relative risk is two to three times higher than normal.[2] It seems that there are likely other mechanisms at play in type 2 diabetes that reduce bone strength and increase the risk for fracture.[2,4]

Monitor your bone health

If you have either type 1 or type 2 diabetes, it is important to make sure your bones aren’t at risk. Be sure to monitor your bone health by getting regular osteoporosis testing.

• The gold standard is the DEXA scan, which measures bone mineral density. For help understanding bone density scores, read more here.
• You can also order other tests that give you additional, helpful information that a DEXA scan cannot, such as the Pyrilinks-D test and the urine NTX and serum CTX tests.

Strategies to keep your bones strong

If you find that you have low bone mineral density or are concerned about your bone health, take preventive measures to strengthen your bones. Supplements like vitamin D, regular physical exercise, and a healthy diet are good places to start. Look at our collection of blogs on Osteoporosis Prevention and Treatment for more information. Also go here to learn how cactus can help fight diabetes too.

Share your experience

Do you have diabetes? Have you ever experienced osteoporosis, fractures, or problems with your bone health? Share your experience in the comments section below.

[1] Osteoporos Int. 2007 Apr;18(4):427-44.

[2] Int J Endocrinol. 2014;2014:820615.

[3] J Osteoporos. 2015;2015:174186.

[4] Curr Osteoporos Rep. 2015 Apr;13(2):106-15.