What Do My Bones Have to Do with Diabetes?

Diabetes may increase your risk of fractures or worsening bone health, which can make diabetes management more challenging. 

You might have already heard how diabetes can affect different parts of your body, like your heart and kidneys. However, you may not have heard about bone health and diabetes.

Part of the reason? The link between bone health and diabetes, especially type 2 diabetes, has less research than the links between diabetes and heart and kidney diseases. And it’s not as straightforward. Diabetes doesn’t cause bone conditions like osteoporosis, but the two can coexist and worsen one another.

Understanding the effects of diabetes on bone health can empower you to take steps to protect yourself and prevent issues like falls and fractures.

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How does diabetes affect bone health?

Research from 2019 suggests that people with type 2 diabetes could have up to a 40% higher risk of fractures. But other factors may increase your risk.

Sex

For example, in a 2017 study including 200 people with type 2 diabetes, postmenopausal women were more likely than men to have osteoporosis, a bone disease that can cause weakness and brittle bones.

Combination of factors

In another 2017 study, researchers found that type 2 diabetes can affect your bone makeup because it affects cells in the bones that help them repair, regenerate, and stay strong. Researchers wrote that it could be due to a combination of factors, including:

• poor blood sugar management and hypoglycemia, which can cause dizziness and lead to falls
• osteopenia, which is a decrease in bone density
• medication side effects that can make you more likely to lose balance or fall

Kidney disease

Your diabetes affects other organs, including the kidneys, which might also affect bone health.

For example, a 2020 study suggests that people with diabetes and chronic kidney disease–related osteoporosis were more likely to experience fractures.

Neuropathy

Have you ever experienced nerve damage that results in tingling and numbness? It usually happens in the legs and feet.

A 2020 meta-analysis of 11 studies that included more than 27,000 people found that people with this complication were much more likely to develop osteoporosis and fragility fractures.

Vision issues

You may have also heard that diabetes increases the risk of vision issues. Eye complications from diabetes can increase the chances of falling and breaking bones.

7 tips for protecting your bones with diabetes

It can be challenging to follow your doctor’s suggestions to manage diabetes if you’ve got bone issues. For example, being physically active is difficult if you’re recovering from a broken bone.

While you cannot control every aspect of your health, you can take steps to protect your bones. The good news? Many of these steps might have a ripple effect and help you manage your diabetes too.

1. Get screened

If your doctor believes you have osteoporosis, they might order a DEXA scan. It’s a 20-minute, low energy X-ray that tests bone density.

But it’s not that simple. Your doctor knows these numbers should only be considered one piece of the puzzle. They’ll also ask you questions to determine your fall or fracture risk. These risk factors might include your sex and age.

2. Eat bone-nourishing foods

You’ve probably been told that diet is the most important thing you can change to control your blood sugar. Ditto for bone health.

Eating foods rich in calcium and vitamin D can improve bone health, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Though our bodies naturally make calcium, we need to get some from food. Good sources of calcium include:

• milk
• cheese
• salmon
• leafy green vegetables

Your doctor might recommend foods rich in vitamin D because it helps our bodies absorb calcium. Time spent outdoors in sunlight might also help you get vitamin D.

You can also ask your doctor whether a vitamin D supplement is right for you.

3. Exercise

Like diet, regular exercise, especially resistance training, can help protect your bones and manage diabetes. NIAMS suggests that exercise can help build strength and improve balance, reducing the risks of falls and fractures.

A personal trainer can help you start and gradually work your way to an exercise routine that’s challenging but right for you.

4. Get some shut-eye

Getting a good night’s sleep is important for overall health, and it might help reduce your risk of falls and osteoporosis too.

Although research is mixed, a 2022 review suggests that sleep disruptions, including how long you sleep and obstructive sleep apnea, might increase your fracture risk and decrease your bone mineral density.

Your doctor can refer you to a sleep study to screen you for sleep apnea.

5. Discuss medications with your doctor

There are many medications approved by the Food and Drug Administration (FDA) to help manage osteoporosis, including:

• bisphosphonates
• parathyroid hormone (PTH) analogs
• RANKL inhibitor
• sclerostin inhibitors
• calcitonin analogs
• selective estrogen receptor modulators (SERMs)

6. Fall-proof your home (the best you can)

You can also work to protect yourself in your own home by reducing potential sources of falls. For instance, the National Institute on Aging recommends:

• holding stair railings when taking the stairs
• keeping stairs well lit with switches at the top and bottom
• using non-skid mats on surface areas that are exposed to water, like bathroom floors
• making your lights easier to reach near your bed
• keeping electrical cords and other items clear of walkways

7. Attend regular doctors’ appointments

Attending regular appointments can help your care team screen you for other issues that can cause poor bone health. Some routine appointments might include:

• blood tests for A1C and vitamin deficiencies
• vision tests
• bone mineral density scans
• medication review
• suggestions for improved diet, exercise, and sleep

Takeaway

There’s no hard evidence to prove that type 2 diabetes causes bone health issues like osteoporosis. However, type 2 diabetes can increase your risk of falls, which puts you at a higher risk of fractures.

Your blood sugar management, medication side effects, kidney disease, and vision problems may all play a role in bone health.

Your doctor might suggest tests, home improvements, or lifestyle changes to prevent your risk. Taking these steps can help you manage diabetes and stay ahead of any new issues.