If you have diabetes mellitus—commonly known as diabetes—you will be aware of potential complications of diabetes that may affect different body organs, including the eyes, kidneys, and heart.
At Atlantic Endocrinology & Diabetes Center we know and understand that there is one more thing risk to consider—and that is your risk for bone diseases.
Compared to people without diabetes, people with type 1 and type 2 diabetes have a higher risk for fractures, especially of the hip.
How diabetes affects bone health
The mechanisms behind diabetic bone disease are not entirely clear. Whether bone fragility happens alongside diabetes or is itself a complication of diabetes is a point of debate.
Diabetes mellitus changes your bone metabolism, which is one of the significant long-term complications we see in diabetes.
Diabetes increases the risk of periodontitis or gum disease. This leads to what we call alveolar bone loss, weakening the bones.
One complication of diabetes is microangiopathy, which is a disease of the small blood vessels. Microangiopathy is a type of microvascular disease related to bone mineral density, bone structure, and bone turnover.
What indicators of bone problems should healthcare professionals look for?
People with diabetes have the same risk factors for fracture as all adults. These risk factors include low BMD, falls, older age, being female, prior fracture, low body mass index, reduced physical activity, use of glucocorticoids, smoking, and consuming too much alcohol.
In patients with diabetes, there are other risk factors to look for, like having the disease for 5 years or longer and high glucose levels. If patients have hypoglycemia, that’s also going to increase their risk for falls and fractures.
At Atlantic Endocrinology & Diabetes Center we also know that some diabetes complications are associated with higher fall and fracture risk. These complications include peripheral neuropathy, poor vision, muscle weakness, and kidney disease NIH external link. They are all targets for treatment.
Bone Diseases Linked to Diabetes
Bone diseases associated with diabetes include osteoporosis, osteopenia, Charcot foot, diabetic hand syndrome, diffuse idiopathic skeletal hyperostosis, frozen shoulder, and Dupuytren’s contracture.
One of the most common bone diseases is osteoporosis, characterized by low bone mass and structural deterioration of bone tissues. It can lead to bone instability and increased risk of fractures of the hips, wrists, knees, and spine.
In osteopenia, bones are weaker than usual. However, bone mass and density are not low enough to cause bones to break easily. Osteopenia can be seen as a middle point between having strong, healthy bones and having osteoporosis.
Also known as Charcot neuropathic osteoarthropathy, Charcot foot is a complication of diabetes that causes deformities in the foot and ankle. Symptoms include swelling, redness, and visible deformity.
Diabetic Hand Syndrome
Diabetic hand syndrome, also known as diabetic cheiroarthropathy, is a complication of both type 1 and type 2 diabetes where finger movement is limited, and the hands become waxy and thick. Diabetic hand syndrome is more common in people with long-standing, uncontrolled diabetes.
Diffuse Idiopathic Skeletal Hyperostosis
Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a type of arthritis that affects tendons and ligaments—mainly in the spine. DISH causes tissues to become calcified (hardened) and bone spurs to develop in areas of the spine that connect to bone.
Frozen shoulder, also known as adhesive capsulitis, results when ligaments around the shoulder become inflamed and stiff. Both inflammation and diabetes make routine healing harder, causing the shoulder joint to become so stiff that it can make the simplest activities—like buttoning a shirt—difficult.
Dupuytren’s contracture, also called palmar fascia, is a hand condition that gradually causes the connective tissues under the skin of the hand to become thick and severely scarred. While the disease is not always painful, it does restrict movement in the fingers and may cause them to curl and bend towards the palm.
High blood sugar increases the fragility of joints and weakens muscles. Managing BSL and ensuring you get sufficient exercise will help reduce the risk of joint problems.
Complement your exercise with a healthy, nutritious diet, preferably plant-based. Of course, the best solution is to fully reverse your diabetes; and this is realistically achievable through a proper plan involving diet, exercise, stress management, and medical supervision.