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Diabetes and Bone Health

by Elsa S. Strotmeyer, PhD, MPH

If any of these factors apply to you, you may want to discuss having a bone density test with your health-care provider. In general, the more of these factors you have, the greater your risk of osteoporosis and fracture.

Several steps can be taken to prevent or treat low BMD. These include eating calcium-rich foods or taking calcium supplements (1,000–1,500 milligrams per day), ensuring adequate vitamin D intake (400–1,000 IU per day), not smoking, not consuming alcohol in excess, and exercising regularly (especially weight-bearing activities such as walking, jogging, stair climbing, and weight training). If you choose to take calcium supplements, take no more than 500 milligrams at a time because your body can’t absorb more than that at once. If you already have osteoporosis, you may want to discuss the variety of drug treatment options available with your doctor.

If you are diagnosed with osteoporosis, it is important to take steps to prevent fractures. However, not all people with low BMD will break a bone, and some people with high BMD will break one. No official recommendation currently exists for fracture prevention that is specific to people with diabetes, since further research is needed to more fully understand how diabetes and fractures are related. However, adults with diabetes may want to observe general fall-prevention measures, which include wearing rubber-soled shoes both indoors and outdoors to prevent slipping, keeping all walkways clear of tripping hazards, maintaining adequate lighting in and around the house, having a grab bar installed in your shower or bath, and placing a rubber mat in the shower or bath. Having your vision and hearing checked regularly, and correcting any problems (with glasses or a hearing aid, if necessary), can also help prevent falls.

Some medicines could make a fall more likely. These include some sedatives and sleeping pills, antidepressants, anticonvulsants, muscle relaxants, blood-pressure-lowering drugs, and medicines for heart conditions. For unknown reasons, taking four or more prescription drugs, regardless of what they are, has also been shown to increase the risk of falls. If the drugs you take fit into any of these categories or you take four or more drugs, you should go over all of your medicines with your doctor and discuss whether there are other treatment options that are less likely to raise your risk of falling.

While not all factors that contribute to osteoporosis are preventable, bone deterioration and fracture are not inevitable. People with a higher risk of bone loss, including those with diabetes, can and should take steps to strengthen and protect their bones.

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