Diabetic osteoporosis, a headache [double killer]

Dr. Clove has talked a lot about the harm of diabetes, but he has mentioned more about the effects of diabetes on kidney, fundus, cardiovascular and cerebrovascular diseases before. For example, in our previous articles, we have mentioned diabetic nephropathy, fundus diseases, cardiovascular and cerebrovascular diseases, diabetic foot, etc.

In fact, there is also a chronic complication of diabetes that occurs in the skeletal system, with great harm, disability and high mortality rate, which is the main cause of long-term pain and dysfunction of body bones in diabetic patients.

It is diabetic osteoporosis that cannot be underestimated.

Osteoporosis is no stranger to people. Dr. Clove has introduced osteoporosis in detail before. Click here to view the album Osteoporosis.

But is there a what link between diabetes and osteoporosis? Is there any difference between diabetic osteoporosis and common osteoporosis in what? Dr. Clove will give you details one by one.

Diabetes can lead to osteoporosis

Osteoporosis can be divided into primary osteoporosis and secondary osteoporosis. Primary osteoporosis is often caused by the decrease of bone formation ability in the elderly or the increase of bone resorption caused by the decrease of estrogen level in postmenopausal women, while diabetic osteoporosis introduced in this article belongs to secondary osteoporosis.

Our bone tissue consists of two parts:

  1. Bone matrix formed by collagen and other proteins;

  2. Bone salts mainly composed of calcium and phosphorus compounds.

Bones are made up of bone salts deposited on the bone matrix. Strong and hard bones are not static. In a sense, our bones are [new] every day. How do you say that? It turns out that our bone is undergoing [bone formation] and [bone resorption] every day, that is to say, bone is continuously absorbed by the body, but at the same time, bone is constantly reformed. This is a dynamic balance process.

However, once this balance is broken, various types of bone diseases may occur. For example, when [bone formation] cannot keep pace with [bone resorption], the amount of bone in the bone will decrease and the microstructure of bone tissue will be destroyed, which will lead to osteoporosis and greatly increase the risk of bone fragility and fracture.

All diseases that destroy the balance can cause osteoporosis. So, what is what’s relationship with diabetes?

Is diabetes how causing osteoporosis?

As we all know, diabetes is the most common endocrine metabolic disease. In addition to metabolic disorders of sugar, protein and fat, diabetes also causes calcium loss and abnormal bone metabolism. There are two main causes of osteoporosis caused by diabetes:

1. Increased excretion and bone loss

The typical symptoms of diabetes are excessive drinking and urination. In this body change, a large amount of calcium and phosphate rock substances will be excreted out of the body along with urine. If the necessary calcium supplement is not available at this time, the patient’s [calcium negative balance] will be caused, which will lead to a series of hormone level changes, promote osteolysis and eventually lead to bone decalcification and osteoporosis.

2. Inadequate calcium absorption and reduced bone synthesis

Active vitamin D can increase the absorption of calcium in the body, while the level of active vitamin D in diabetic patients is often low, which affects the absorption of minerals such as calcium and phosphorus in intestinal tract.

The decrease in insulin sensitivity peculiar to type 2 diabetes is even worse for bone damage. It will affect the normal metabolism of protein and reduce bone matrix synthesis.

The combination of all these factors will eventually lead to the reduction of bone matrix, destruction of bone trabecula and reduction of bone density in diabetic patients, thus becoming a high-risk group for osteoporosis onset.

The manifestations of this osteoporosis are quite different.

Due to the different mechanisms leading to diseases, diabetic osteoporosis and primary osteoporosis also have great differences in disease manifestations, treatment methods and life conditioning.

1. Different disease manifestations

The clinical manifestations of diabetic osteoporosis include both diabetes and osteoporosis.

This kind of osteoporosis is more common in elderly diabetics with a long history, In the early stages of the disease, Patients often have no obvious symptoms, However, with the progress of the disease, waist and back pain, hunchback deformity, shorter height, limb weakness and calf cramps will gradually occur. Severe cases may even have spontaneous fracture or fracture under slight external force (such as cough, sneezing, bending, weight bearing, squeezing, falling, etc.), with thoracolumbar spine, hip and wrist being the most common fracture sites.

2. Different treatments

Treatment of diabetes is the most important thing in the treatment of diabetic osteoporosis.

The so-called [skin does not exist, how can hair be attached], diabetes condition control is stable, also released the major inducement of osteoporosis.

3. Diet and exercise conditioning are different,

The content of calcium, magnesium and zinc in the routine diet of diabetes is obviously insufficient. Therefore, diabetic patients should maintain a balanced nutrition and cannot go on an excessive diet. Usually, they should eat more foods rich in calcium, such as dairy products such as milk, green leafy vegetables rich in calcium, beans, etc. This is the premise and foundation for preventing, delaying and treating osteoporosis.

Exercise is equally important. Regular aerobic exercise, Such as jogging, fast walking, swimming, etc., can not only help diabetics control blood sugar and weight, but also help to strengthen bones and prevent osteoporosis. In addition, sufficient sunlight can promote skin to synthesize more active vitamin D and promote calcium absorption in intestinal tract. Therefore, it is recommended that diabetics have not less than half an hour of sunlight every day.

In addition, diabetics must also give up all living habits that are not conducive to bone health, such as smoking, drinking too much, drinking too much coffee, strong tea, etc.

Good news and bad news

Diabetes can lead to and aggravate osteoporosis, which is bad news.

The good news is that compared with the treatment of primary osteoporosis, the onset of effect is slow, the course of treatment is long, and the effect is not obvious. After effective treatment, diabetic osteoporosis takes effect faster, the course of treatment is relatively short, and the effect is more obvious.

Of course, the actual situation is always much more complicated than the theoretical situation. Because many diabetics have the causes of primary osteoporosis such as age increase, less activity, lower sex hormone level and heredity. Therefore, In clinical work, diabetic osteoporosis and primary osteoporosis often coexist, and sometimes it is difficult to distinguish them strictly. However, these difficulties can be left to doctors to study slowly. For patients, only need to understand: diabetes, to treat; Osteoporosis should be treated even more.

As diabetic patients, in addition to controlling blood sugar, we should care about kidneys, eyes, cardiovascular and cerebrovascular diseases, lower limb foot diseases, and don’t forget to care about our increasingly loose bones.

Responsible Editor: Cat Capricorn