Diabetes is a chronic and progressive disease that is characterized by high blood sugar levels. It affects millions of people worldwide and is a major cause of morbidity and mortality.
Diabetes has been associated with an increased risk of fractures, which can lead to significant disability and higher healthcare costs. In this article, we will discuss the risk of fractures in people with diabetes and the factors that contribute to this risk.
What is Diabetes?
Diabetes is a chronic disease that affects how your body turns food into energy. When you eat food, your body breaks it down into glucose, which is then used as fuel by your cells.
Insulin, a hormone made by the pancreas, helps to regulate the amount of glucose in your blood. In people with diabetes, the body either does not make enough insulin or is unable to use it effectively, leading to high blood sugar levels.
Types of Diabetes
There are three main types of diabetes:.
Type 1 Diabetes
Type 1 diabetes, also known as juvenile diabetes, usually develops in children and young adults. It occurs when the body’s immune system attacks and destroys the cells in the pancreas that make insulin.
People with type 1 diabetes need to take insulin injections or use an insulin pump to manage their blood sugar levels.
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes. It usually develops in middle-aged or older adults, but it can also occur in children and young adults.
In people with type 2 diabetes, the body is unable to use insulin effectively, leading to high blood sugar levels. This is often due to a combination of genetic and lifestyle factors, such as obesity and physical inactivity. Type 2 diabetes can sometimes be managed with lifestyle changes, such as diet and exercise, but many people also need medication.
Gestational Diabetes
Gestational diabetes occurs during pregnancy and usually disappears after the baby is born. However, women who have had gestational diabetes are at higher risk of developing type 2 diabetes later in life.
The Link Between Diabetes and Fractures
Studies have shown that people with diabetes are at higher risk of fractures than people without diabetes. The reasons for this increased risk are not fully understood, but there are several factors that may contribute to it.
Related Article
Diabetes Increases Fracture Risk
Changes in Bone Quality
Diabetes can affect the quality of your bones, making them weaker and more prone to fractures. This is due to several factors, including:.
- Changes in bone structure: People with diabetes may have changes in the microarchitecture of their bones, which can weaken them.
- Reduced bone density: Diabetes can cause a decrease in bone density, which can increase the risk of fractures.
- Advanced glycation end products (AGEs): When blood sugar levels are high, they can cause the formation of AGEs, which can damage the collagen in your bones and make them more brittle.
Increased Risk of Falls
People with diabetes are also at higher risk of falls, which can lead to fractures. This may be due to several factors, including:.
- Neuropathy: Diabetes can cause nerve damage, which can lead to reduced sensation in the feet and legs. This can make it harder to detect uneven surfaces or obstacles, increasing the risk of falls.
- Foot problems: Diabetes can also cause foot problems, such as ulcers, that can make walking more difficult and increase the risk of falls.
- Visual impairment: Diabetes can cause eye problems, such as retinopathy, which can affect vision and increase the risk of falls.
Medications
Some medications used to treat diabetes, such as thiazolidinediones (TZDs), have been associated with an increased risk of fractures.
TZDs work by increasing the sensitivity of your body’s cells to insulin, but they can also reduce bone mineral density and increase the risk of fractures, particularly in women.
Who is at Risk for Fractures?
While everyone with diabetes is at increased risk of fractures, some people may be at even higher risk. Factors that can contribute to a higher risk of fractures include:.
- Advanced age
- Female gender
- History of previous fractures
- Poor glycemic control
- Low bone mineral density
- Use of medications that increase fracture risk
Preventing Fractures in People with Diabetes
Preventing fractures in people with diabetes requires a multifaceted approach that addresses both the underlying risk factors for fractures and the individual’s specific needs.
Lifestyle Changes
There are several lifestyle changes that can help reduce the risk of fractures in people with diabetes:.
- Exercise: Regular weight-bearing exercise, such as walking or strength training, can help improve bone density and reduce the risk of falls.
- Diet: A diet rich in calcium and vitamin D can help support bone health.
- Foot care: Regular foot exams and proper shoe selection can help reduce the risk of foot problems and falls.
Medications
Some medications may be helpful in preventing fractures in people with diabetes:.
- Bisphosphonates: These medications can help improve bone density and reduce the risk of fractures, but they may have side effects and are not appropriate for everyone.
- Denosumab: This medication works by inhibiting the cells that break down bone, helping to improve bone density and reduce the risk of fractures.
- Teriparatide: This medication stimulates the cells that build bone, helping to increase bone density and reduce the risk of fractures. It is usually only used in people with severe osteoporosis.
Conclusion
Fractures are a common complication of diabetes, but there are steps that people with diabetes can take to reduce their risk.
Maintaining good blood sugar control, getting regular exercise, and taking medications as prescribed can all help improve bone health and reduce the risk of fractures. It is also important for people with diabetes to be aware of their individual risk factors for fractures and to work with their healthcare providers to develop a personalized prevention plan.
