Osteoporosis and Diabetes – Special Considerations

osteoporosisWhile not fully understood, there is a clear link between osteoporosis and diabetes. Osteoporosis occurs when your bone density lessens making them more likely to fracture. Approximately 44 million Americans have osteoporosis, 68% are women. The good news is that osteoporosis is preventable. The bad news is that, if undetected, it can progress for years without any symptoms.

What is the link between the two? Type 1 and Type 2 diabetes are linked to causing low bone density, although scientists are not clear why. Type 1 diabetes usually occurs at a young age, while bone density is still increasing. One theory suggests that the insulin may promote bone density.

As Type 1 diabetics do not produce enough insulin naturally, this leads to lower bone density. Another theory suggests that Type diabetics often have celiac disease, which can reduce bone mass. A contributing factor may be that diabetes causes vision problems, leading to an increase in falls and bone fractures.

The link with type 2 diabetes presents even more conjecture. Individuals with type 2 diabetes are often over weight, which is a factor in increasing bone density. Thus, it was believed that Type 2 diabetics were not prone to osteoporosis. However, bone fractures are increased, so it may be that vision related complications add to osteoporosis in diabetics.

Conversely, a sedentary lifestyle also negatively impacts bone density. Bottom line is that there is a strong link between osteoporosis and diabetes; however, scientists are still wrestling with why this occurs. They do however have an idea of the risk factors associated with the conditions.

Risk Factors

  • Thin or slight framed individuals
  • Family history
  • For Women (postmenopausal, early menopause, amenorrhea (no periods))
  • Calcium deficient
  • Lack of exercise (particularly Strength Training)
  • Smoking
  • Excessive Alcohol

Preventing and treating osteoporosis in people with diabetes is the same as those without diabetes.


Calcium and Vitamin D are essential for healthy bones. According to the National Institute of Health (NIH) calcium is prevalent in low fat dairy products, calcium fortified foods and beverages, and dark leafy vegetables.

The NIH also reports that nutritional supplements are also an important source of calcium and other essential nutrients. Vitamin D helps with calcium absorption and bone health. People typically obtain enough vitamin D through exposure to sunlight. Unfortunately, as we age this becomes a problem. Older people may also require vitamin D supplements.


Bones are living tissue that benefit from exercise, just like muscles. Recommended activity includes, walking, stair climbing, and dancing. A corresponding benefit of exercise is that it increases coordination, flexibility and balance, all of which help reduce the chances of falling and breaking a bone.

Lifestyle Choices

Smoking and drinking are bad for bones. Smoking reduces absorption of calcium and in women can cause early menopause, leading to lower bone density. Alcohol can lead to poor nutrition and increased risk of falling.


There is no cure for osteoporosis, however certain medications can prevent and treat the condition. Approved Food and Drug Administration drugs include alendronate, risedronate, ibandronate, raloxifene, calcitonin, teriparatide. Please consult your physician to see if any of these are appropriate for you.

Bone Density Testing

osteoporosis2Bone Mineral Density (BMD) tests measure a persons bone density. The most common test BMD test is the dualenergy x-ray absorptiometry (called the DXA). This test is very similar to an x-ray test and measure the bone density at the hip and spine areas. Diabetics should consult with their physician to determine if a BDM test is right for them.

There you have it. Probably more than you wanted to know about osteoporosis and diabetes! All joking aside, make sure you incorporate some of these suggestions into your life and talk to your doctor about how to stay on top of this issue.

National Institute of Health, Conditions and Behaviors that Increase Osteoporosis Risk, November 2006 (Accessed December 2008).
By Erich Schultz – Last Reviewed March 2013.