Diabetes and osteoporosis are comorbidities that affect each other. Diabetes can put you at a higher risk for developing osteoporosis, and if you have osteoporosis, it may make managing your diabetes more difficult.

Diabetes mellitus and osteoporosis are two conditions that can affect people at the same time. The connection between these two conditions is complicated, but they don’t cause each other.

Having diabetes increases your risk for osteoporosis, and having osteoporosis can make diabetes management harder. This article will explain more about how the two conditions are related and what you can do to best manage both.

Diabetes does not cause osteoporosis.

However, having diabetes — especially type 1 diabetes — does raise your risk of developing osteoporosis.

This is because people with type 1 diabetes often have weaker and poorer bone density and a higher risk of fractures, as much as a sevenfold higher rate for some broken bones for those with type 1 diabetes between 20 and 60 years old.

Factors that increase or decrease your risk of bone fractures include:

  • the length of time you’ve had diabetes
  • blood sugar management, especially if you’re more prone to low blood sugar
  • whether you take insulin or not, as that can tie in with low blood sugar drops that lead to higher risk

Diabetes can affect bones in several ways.

Both type 1 and type 2 diabetes can increase osteoclast function but decreases osteoblast function, leading to accelerated bone loss, osteopenia, and osteoporosis. Chronic high blood sugar induces the production of macrophage colony-stimulating factor (MCSF), which further degrades bone density.

Bone density is also reduced as a result of advanced glycation end products (AGEs) production. AGEs are proteins or lipids that become glycated after exposure to sugars, like the extra glucose in the bloodstream of people with diabetes. AGEs are usually prevalent in diabetic vasculature, contributing to low impact or fragile bone fractures.

Some complications of diabetes, including muscle weakness, vision issues, low blood sugar, and neuropathy in the feet can lead to an increase in falls and resulting in fractures.

Both lower bone mass and a history of fractures increase one’s risk of developing osteoporosis later in life.

Osteoporosis is a disease that can often be prevented with the right strategies.

There are several ways to help protect your bones if you have diabetes:

Request a bone-density test

Ask your doctor for a bone-density test, like the DEXA scan. This is a low dose X-ray that tests your bone mineral density (BMD). It can be done in fewer than 20 minutes and can give you real-time feedback on how high risk you are for bone loss and osteoporosis.

Focus on nutrition

People with diabetes are notoriously low on vitamin D. However, vitamin D is essential for the body to properly absorb and utilize calcium. Focus on getting more of both, either through food or a daily supplement.

If you suspect that your vitamin D levels are low, ask your doctor for a blood test to see. If they are low enough, you can get a prescription strength vitamin D supplement.

For people 1 year and older, aim for at least 15 mcg (600 IU) of vitamin D daily. For children younger than 1 year old, talk with your doctor. People with diabetes may need more than 600 IU daily to increase their vitamin D levels if they’re low. Adults over 71 years are recommended to take 800 IU.

Talk with your doctor about your individualized daily vitamin D recommendations.

Exercise regularly

Regular exercise, especially strength training and weightlifting, can help keep your bones strong. Exercising regularly helps prevent bone loss, and it improves not only your strength but your balance and flexibility. Cumulatively, this can help prevent falls, which increase your risk of developing osteoporosis.

Exercise also helps people with diabetes keep their blood sugar levels within a healthy range, so physical activity really helps both conditions at once.

Maintain a healthy lifestyle

The following lifestyle changes can help protect your bones from osteoporosis and lower your risk of falls:

  • Avoid smoking. Smoking inhibits the absorption of vitamins into your body.
  • Limit alcohol consumption.
  • Get some sunshine, which is another great source of vitamin D.
  • Eat a nutritious diet.
  • Take vitamin D and calcium supplements.
  • Maintain moderate blood sugar levels.
  • Get your eyes and vision checked regularly.
  • Get regular exercise.

These healthy living strategies also improve diabetes management, making them smart choices for anyone with osteoporosis, diabetes, or both.

Having osteoporosis can impact your diabetes in several ways.

You may be more likely to break bones if you’re subject to frequent falls, which can be dangerous if you have vision issues from your diabetes or experience frequent low blood sugar.

Additionally, having osteoporosis can make regular physical activity more difficult, which can make blood sugar management more stressful and frustrating.

Considering talking with your doctor if you have osteoporosis and it’s negatively affecting your diabetes management. They may have suggested strategies that can help you.

There are several medications that are approved by the Food and Drug Administration (FDA) for people who have osteoporosis and diabetes.

Bisphosphonates are the recommended first-line treatment for osteoporosis therapy in people with diabetes. For people with diabetes who are elderly or have impaired kidney function, denosumab is a preferred medication.

In people with severe osteoporosis, anabolic agents may be considered.

Consider consulting your doctor before starting any new treatment regimen or before taking any medication if you have both osteoporosis and diabetes.

Osteoporosis and diabetes are comorbidities, but one condition doesn’t cause the other. Diabetes can put you at a higher risk for developing osteoporosis, and if you have osteoporosis, it may make managing your diabetes more difficult.

There are ways to help protect your bone health and prevent osteoporosis if you have diabetes, including making sure you’re getting enough calcium and vitamin D supplementation, exercising regularly, including strength training, getting a bone-density test, avoiding smoking, limiting alcohol, and maintaining healthy blood sugar levels.