The Overlooked Connection Between Diabetes and Bone Health

Understanding the relationship between diabetes and bone health is crucial. Dr. Adarsh K S, a consultant in diabetes and endocrinology at Manipal Hospital, highlights the risks associated with diabetes and its impact on bone density.

Diabetes, particularly type 1 and type 2, can lead to a higher risk of fractures. Type 1 diabetes often results in lower bone density, while type 2 diabetes can lead to poor bone quality despite normal or high bone density. This discrepancy makes individuals with type 2 diabetes more susceptible to fractures.

Why Does Diabetes Compromise Bone Health?

Dr. Adarsh explains that diabetes mellitus is characterized by chronic high blood sugar levels, which adversely affect bone health. The effects differ between type 1 and type 2 diabetes. Type 1 diabetes decreases bone mineral density, especially when diagnosed at a young age. In contrast, type 2 diabetes is often linked to metabolic issues and obesity, leading to compromised bone quality.

Interestingly, conventional assessments for fracture risk, like bone density tests, may underestimate the risk for diabetic patients. While these tests are useful for measuring density, they do not always account for the changes in bone quality associated with diabetes.

Assessing Bone Health in Diabetic Patients

Although high-resolution imaging techniques can assess bone quality, they are not widely accessible. Dr. Adarsh suggests that Trabecular Bone Score (TBS) could be a valuable tool for evaluating bone microarchitecture, particularly in type 2 diabetes patients with preserved bone density.

Additionally, serum bone turnover markers can provide insight into bone health. Markers like Procollagen type 1 N-terminal propeptide (P1NP) and C-telopeptide (CTX) indicate bone production and resorption, respectively. Monitoring these markers is crucial for identifying diabetic bone disease.

In conclusion, managing diabetes effectively requires a comprehensive approach that includes monitoring bone health. Patients should work closely with their healthcare providers to ensure they are aware of the potential risks and to adopt necessary lifestyle and dietary modifications.