Health care knowledge that people with diabetes must know

The bone density of patients with type 1 diabetes is low, while the bone density of patients with type 2 diabetes is sometimes not low or even slightly higher than that of normal people, but they are also prone to fractures. Why are people with diabetes prone to fractures?

1. Hypoglycemic events lead to an increased risk of falls.

2. Hyperglycemia leads to an increase in glycation end products: Here is an explanation of what glycation end products are?

We all know about glycated hemoglobin, which reflects the average 3-month blood sugar level, but did you know? Glycated hemoglobin is actually the product of the combination of glycation end products and hemoglobin. If this glycation end product can bind to proteins on bones such as collagen, it will definitely affect the function of these proteins and thus hinder osteogenesis.

Some people have said that in adults, the bones are already set, so why should we be afraid of osteogenic disorders? In fact, adult bones also have metabolism. For example, if you accidentally knock yourself today, you may see local skin ecchymosis, but the bones may have "microfractures". This kind of "microfractures" requires Its own osteogenic function repairs it. If there is a disorder in the osteogenic function and you bump into something frequently, you are likely to have obvious fracture symptoms.

3. Excessive strict diet control leads to poor puberty development in children and adolescents, delayed menarche in girls, or irregular menstruation. We all know that gonadal hormones play an important role in bone growth and development. Women are prone to osteoporosis after menopause, and the same is true for late or irregular menstruation.

4. Certain hypoglycemic drugs can also affect bone metabolism. There is currently a lack of rigorously designed research on the effects of antidiabetic drugs on bone metabolism, so it is still unknown how much impact many drugs have on bone.

As far as known data is concerned:

Metformin may have beneficial effects on bone, at least without adverse effects.

Thiazolidinediones, either rosiglitazone or pioglitazone, increase the risk of fractures.

Newly launched DPP-4 enzyme inhibitors, such as sitagliptin, saxagliptin or linagliptin, have a neutral effect on bone.

There is not much data on SGLT2 inhibitors, but existing evidence shows that empagliflozin may affect bone metabolism indicators and even increase the risk of fractures.
5. Increased risk of falls due to complications of diabetic microvascular complications, such as retinopathy or neuropathy.

6. Other unknown factors.

The above is the impact of diabetes on bones. Next, let’s talk about the impact of bones on diabetes. This is a popular research result in recent years! The relationship between blood sugar and bones

The latest research shows that bones can also secrete many cytokines, which can also affect insulin resistance, food intake, and even the process of glucose metabolism. For example, Lcn2, expressed by osteoblasts, can improve insulin resistance, inhibit food intake, and thereby regulate glucose metabolism;

Another example is osteocalcin, which is also involved in the pathogenesis of insulin resistance. Of course, these studies are relatively basic, so they will not be described in detail here.

Normal people fall, get up, dust themselves off, and walk as usual; but type 2 diabetic patients fall and break bones! Therefore, people with diabetes should pay attention to supplementing calcium, controlling blood sugar, and reducing the chance of fractures.