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

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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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