Osteoporosis: Yet another Complication of Diabetes? (Part 3)

I hope you all had an enjoyable and relaxing Thanksgiving. It’s hard to believe that December is here already.


This week, we’ll wrap up the series on osteoporosis by leading off with steps you can take to prevent it.

Osteoporosis is debilitating, and while we’re fortunate now to have a small arsenal of drugs to help treat it, it’s always best to focus on trying to prevent it in the first place. The catch, of course, is to take steps when you’re young because, unfortunately, you can’t turn back the hands of time. But no matter what your age is, there are measures you can take to prevent your bones from becoming more fragile. A combination of diet and supplements, exercise, and lifestyle factors can help your bones stay strong.

More of these:

  • Calcium. No surprise here. Calcium is a key component of bone and is necessary for good bone health. Heart-healthy sources of calcium include nonfat and low-fat milk and yogurt, reduced-fat cheese, sardines and salmon (with the bones), soy products (tofu, soy nuts, soy cheese, soy milk), and green leafy vegetables, such as broccoli, kale, Swiss chard, and bok choy. You can get calcium-fortified orange juice, but watch the carbohydrate. Calcium supplements are often needed, especially for women.
  • Vitamin D. This “sunshine vitamin” is necessary for calcium absorption. Fortified milk and cereal, egg yolks, tuna, sardines, salmon, supplements, and, of course, sunshine (10–15 minutes a day) are key sources.
  • Vitamin K. This fat-soluble vitamin seems to play a role in building up bone mass and reducing fracture rates. While it’s too soon to recommend taking a vitamin K supplement, get your vitamin K fix from green leafy vegetables, fortified cereals, green peas, and carrots.
  • Exercise. Of course, exercise is beneficial! Weight-bearing exercise (walking, jogging, dancing, biking, weight-lifting) helps build strong bones. Swimming, while a great exercise, is non-weight-bearing.

Less of these:

  • Protein. Despite the popularity of high-protein diets for weight loss, too much protein can cause loss of calcium from the bones. Moderation is the ticket.
  • Cola drinks. Some evidence shows that women (but not men) who drink cola beverages (but not other types of soda) have lower bone density than women who don’t. This may be due to the phosphorous found in the cola.
  • Caffeine. Keep your coffee intake to no more than about three cups a day. Caffeine may leach calcium from bone.
  • Alcohol. More than two drinks per day may affect calcium absorption.
  • Smoking. Smoking, besides wreaking havoc on just about every system in the body, lowers bone density, increases fracture risk, and slows fracture healing. If you smoke, stop.

Diabetes and Osteoporosis
There seems to be a link between diabetes and osteoporosis. In fact, there’s been a fairly long-standing association between Type 1 diabetes and this bone disease, with a significant increase in hip fractures among women with Type 1 diabetes compared to women without diabetes.

According to the Iowa Women’s Health Study, women with Type 1 were 12 times more likely to have had a fracture compared to women without diabetes. So, it seems that the longer one has Type 1, the greater the chances of osteoporosis. Why would this happen?

It’s possible that insulin somehow plays a role in helping a person build bone mass. And since many people with Type 1 develop diabetes at a fairly young age, perhaps they never really get a chance to build up sufficient bone density. Furthermore, women with Type 1 may have a higher risk of osteoporosis due to their already increased risk of hypoglycemia. Frequent hypoglycemic episodes can increase the chances of falling, and therefore, the chances of having bone fractures.

People with Type 2 diabetes aren’t necessarily off the hook either. It was thought that, because people with Type 2 diabetes tend to have an increased body mass, they would be protected against osteoporosis. However, people with Type 2 are more likely to suffer fractures due to falls, possibly because of decreased vision and neuropathy.

Bottom line: Do what you can to protect your bones and know your risk factors for osteoporosis.

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  • Jan Putnam

    Have gout in feet.
    Why pain between knees and feet?

  • acampbell

    Hi Jan,

    Gout is a type of arthritis that affects joints, causing severe pain, redness and tenderness. This occurs due to a buildup of uric acid crystals that cause inflammation. Gout primarily affects the big toe, but can also occur in the feet, knees, ankles, hands and wrist. People with diabetes are at increased risk for gout. Do you know for sure that you don’t have gout in your knees? Your pain may be due to other issues, as well, such as neuropathy and/or peripheral vascular disease, for example. Hopefully you’re being treated for your gout and that you’re not in pain. If the pain in your legs persists, you should see your physician to find out what else may be going on.

  • CalgaryDiabetic

    Dear Jan.

    Gout is not fun. I have suffered all my life and even my daughter that is not diabetic and looks like Twiggy (a British model that was skin and bones) gets a gout attack occaisionally.

    We both have solved the problem without medication by religiously following 2 rules:

    1) Wear 100%(or as high as possible) thick wool all year around.

    2) Drink as much as possible, water only and definitely not beer or anything alcoholic.

    As Amy has explained the problem is caused by uric acid crystals in the joints typically the big toe. Warmth ensures that the crystals dont form. Drinking a lot of water washes the offending substance out of the body.

    If this does not cure the problem 100% ask your Doctor to give you a list of foods to avoid that contain purines the precursor of uric acid. In my case brook trout was super toxic but rainbow and brown trouts are fine and I have not a clue why.

    In the last resort there is a drug called Allopurinol that prevents the formation of uric acid in the body with who knows what nasty side effects.

    Good Luck.