No Bones About It: Diabetes and Osteoporosis

AADE Program Session
Saturday, August 14, 2004
10:00 AM - 11:00 AM

Osteoporosis affects about 10 million Americans, and another 18 million people in the US have low bone mass. It is now becoming evident that there is a link between diabetes and osteoporosis. A recent study found that mean A1C value is inversely related to tibia trabecular bone density in adolescents with type 1 diabetes. Other research has shown that adult women with type 1 diabetes have relatively decreased bone mass, increased fracture risk, and delayed fracture healing. The reason diabetes affects bone mass is unknown. Researchers believe there may be decreased bone turnover and impaired osteoblast maturation and function in patients with diabetes. There is also an increased fracture risk in patients with diabetes, despite normal bone mass. Neuropathy and vision impairment may contribute to the risk of falling and fracture.

Patients with diabetes should be especially diligent about reducing the risk factors associated with osteoporosis. These risk factors include smoking, inactivity, poor nutrition, and excessive alcohol use. Physicians who treat patients with diabetes should be mindful of recommended bone density tests and schedule them when appropriate, and appropriate osteoporosis medications should be prescribed as necessary. Physicians should also discuss with their patients the importance of getting enough calcium and vitamin D, either through good nutrition (preferred) or calcium supplements.