Diabetes Increases the Risk of Fractures

09 September, 2020
Diabetic patients are at higher risk of fractures. In this article, we'll be talking about the bones that are affected the most frequently and about ways to prevent this problem.

Among all the complications that may come with diabetes, the increased risk of fractures is one of the greatest. Diabetes is a metabolic disease, however, it doesn’t only affect the presence of substances in the blood. In this disease, blood glucose increases along with the possibility of suffering from other pathologies.

There are several causes of the way increased sugar in the circulation affects the bone tissue. Nonetheless, it’s possible to take preventive measures. Keep reading to learn more.

Metabolism in diabetic patients

As we said previously, diabetes is a metabolic disease. The primary sign of its appearance is the increase in blood sugar concentration. This is usually noticeable on an empty stomach, before eating any kind of food.

As a metabolic pathology, diabetes not only affects blood glucose but also modifies lipid, protein, and mineral balances. Insulin, which is the altered hormone in this case, exerts influence on many bodily processes.

Now, the well-known complications of this disease have to do with the heart and the kidney. However, we must add the impact it has on bone tissue as well. Bones depend on both calcium levels and the ability of bone cells to produce them.

Causes of fractures in diabetes

Both men and women with diabetes are at higher risk of fractures. Hormonal alterations, inflammation, and even some medications have to do with this complication. What other possible triggers are there?

Neuropathy

Long-term high blood glucose damages the fat coating of neurons. Nerves, especially those in the lower limbs, begin transmitting nerve impulses in a less effective way. Collaterally, diabetic neuropathy disturbs balance so people with this illness tend to fall more.

Read also: Effective infusions for improving the nervous system

Dysautonomia

This term refers to the poor function of the nervous system, especially the autonomic one. This is the part of the nerves that regulates and controls all those functions that don’t need a direct and conscious command.

In this way, when it comes to diabetic dysautonomia, patients have difficulty maintaining blood pressure when standing up. As a result, they tend to faint and feel dizzy, which many times leads them to fall and suffer from fractures.

Osteoporosis

Osteoporosis is more common among diabetics than in the rest of the population. Insulin is an anabolic hormone which stimulates the manufacture of tissues. Since they don’t produce it as they should, the bone-repair process becomes slower.

Retinopathy

Retinopathy is another major complication of diabetes. The small arteries located in the retinas break without being able to clot, and this, as a consequence, affects vision. Of course, any disturbance in vision increases the chance of falling and fracturing something.

What fractures are the most frequent in diabetic patients?

Several pieces of research carried out in diabetic patients have been able to establish the relative frequency of fractures they have. This is great because they serve as a guide as to which parts of the body are the most frequently fractured in these patients.

First off, there’s type 1 diabetes. In this case, there isn’t enough insulin in the person’s body so they need to get more externally and artificially. Those with type 1 diabetes tend to suffer from osteoporosis, as well as problems with vision.

Read also: 10 exercises and foods for good vision

Hypoglycemia also plays a key role in this case since many patients tend to mix up the appropriate doses for each moment of the day. As you probably know by now, low sugar levels bring dizziness which can, in turn, bring accidents.

Now, in this type of diabetes, the most common fractures are those of the hip and spine. This was particularly noted in those with established cardiovascular and renal comorbidities.

On the other hand, in type 2 diabetes, the most common fractures are those of the forearm and hip. Although the bone density of these patients isn’t very different from that of the rest of the population, professionals suspect that sugar affects bone mechanics.

A diabetic patient measuring his blood sugar level.

How to prevent the risk of fractures in the case of diabetes

Although statistics indicate an increased risk of fractures among diabetic patients, there are things you can do (beyond glycemic control) to prevent that damage.

As previously mentioned, the most important thing here is to consult a specialist and follow up with them on a constant basis. The patient must follow a strict diet and take medication to keep their sugar levels within the normal range so that cardiovascular and kidney problems don’t occur.

Moreover, physical activity is extremely important here. In case you didn’t know, diabetes increases the risk of fractures in people who are sedentary and who have less muscle mass. Doing sports helps sugar enter the muscle and strengthens bone tissue.

Incorporating vitamin D to the body is something we must touch on as well. Most people like to do this by exposing themselves to the sun on a frequent basis. This can be supplemented artificially with medications that are indicated when the person’s values are very low or if they live in cold areas with little sunlight during the year.

Green leafy vegetables are a good option to incorporate vitamins and calcium, which one can also obtain from dairy products. A regular supply of these foods helps bones to regenerate and maintain their internal density. As a result, fractures become less likely.

A close-up of a weak bone, representing the risk of fractures in diabetic patients.

Densitometry is important

In addition to taking preventive measures, diabetic patients should undergo densitometry. This study measures bone concentration and allows sufferers to know if the risk of fractures is high due to weaker tissue.

All patients can take control of the disease and apply self-care measures. However, it’s vital to remember the importance of following up with a professional and taking the necessary precautions to reduce the risk of bone damage.

  • Avogaro, Angelo, et al. “Continued efforts to translate diabetes cardiovascular outcome trials into clinical practice.” Cardiovascular Diabetology 15.1 (2016): 111.
  • Velasco, M. Botas, et al. “Actualización en el diagnóstico, tratamiento y prevención de la neuropatía diabética periférica.” Angiología 69.3 (2017): 174-181.
  • Moreno, Luis, and Mayra Guerrero. “Características de la neuropatía autonómica cardiovascular en pacientes con Diabetes Mellitus tipo 2.” Boletín Médico de Postgrado 35.1 (2019): 48-53.
  • Romero-Aroca, Pedro, and R. Sagarra. “La retinopatía diabética e hipertensiva.” Revista COMCORDOBA 14.7 (2018): 382-393.
  • Martínez, Sonsoles Botella, et al. “La paradoja diabética: densidad mineral ósea y fractura en la diabetes tipo 2.” Endocrinología y Nutrición 63.9 (2016): 495-501.
  • Formiga, Francesc, María Daniela Freitez Ferreira, and Abelardo Montero. “Diabetes mellitus y riesgo de fractura de cadera. Revisión sistemática.” Revista Española de Geriatría y Gerontología 55.1 (2020): 34-41.
  • Martínez Laguna, Daniel. Efecto de la diabetes mellitus tipo 2 sobre la incidencia de fractura osteoporótica. 2017.
  • Navarro Despaigne, Daysi Antonia, and Alina Acosta Cedeño. “Osteoporosis y tratamiento para la diabetes mellitus.” Revista Cubana de Endocrinología 30.1 (2019): 50-53.
  • de Endocrinología Diabetes, Asociación Colombiana. “Metabolismo Óseo.” Revista Colombiana de Endocrinología, Diabetes & Metabolismo 4.2 (2017): 89-90.
  • Duran-Agüero, Samuel, Leslie Landaeta-Díaz, and Lilia Yadira Cortes. “Consumo de lacteos y asociacion con diabetes e hipertensión.” Revista chilena de nutrición 46.6 (2019): 776-782.