Add Bone Deterioration to Diabetes Complications for
12.2 million, or 23.1 percent, of all people age 60
and older have diabetes.
Nov. 12, 2013 - The list of complications from
type 2 diabetes is long: vascular and heart disease, eye problems,
nerve damage, kidney disease, hearing problems and Alzheimer's disease.
Physicians have long thought of
osteoporosis as another outcome. Based on a
Mayo Clinic study published in the
Journal of Bone and Mineral Research, that's confirmed: You can
definitely add skeletal problems to that list.
"This is the first demonstration using direct
measurement of bone strength in the body of compromised bone material
in patients with type 2 diabetes," says
Sundeep Khosla, M.D. , Mayo Clinic
endocrinologist and senior author of the study. "Clearly, the
skeleton needs to be recognized as another important target of diabetes
Previous studies in the field showed that patients
with diabetes experienced fractures at levels of bone density above that
of the regular population, hinting that something was different about
the "quality" of their bone.
The Mayo researchers validated that
assumption in a clinical study of 60 postmenopausal women, 30 of whom
had type 2 diabetes.
Using a new tool (OsteoProbe), the researchers
performed micro indentation testing of the tibia (actually causing a
microscopic crack) to measure bone material strength.
Compared to the
control group of women, aged 50 to 80, the group with type 2 diabetes
had significantly lower bone material strength. There was no difference
between the microarchitecture of the bone or bone density between the
The study showed that diabetic women with lower
bone material strength had also experienced higher levels of
hyperglycemia over the previous 10 years, suggesting potential
detrimental effects of poor glucose control on bone quality.
The resounding message: Conventional measurements
underestimated the risk of fracture among patients with type 2 diabetes
and loss of bone material strength, or bone quality, is a clear,
downstream consequence of the disease.
The new technology may help in
studying other conditions where fractures occur at higher than expected
bone density, says co-author and rheumatologist
Shreyasee Amin, M.D. She says this will be especially relevant to
many forms of autoimmune arthritis where glucocorticoids are used, such
as in rheumatoid arthritis. The team says more research needs to be
done, as this was a small study in a limited population. The studies
were supported by the
National Institutes of Health, including funding from Mayo's
Clinical and Translational Science Award.
Mayo Clinic is a nonprofit worldwide leader in
medical care, research and education for people from all walks of life.
For more information, visit
About Diabetes at MedlinePlus
Diabetes is a disease in which your
blood glucose, or
blood sugar, levels are too high. Glucose comes from the foods you
eat. Insulin is a hormone that helps the glucose get into your cells to
give them energy. With
type 1 diabetes, your body does not make insulin. With
type 2 diabetes, the more common type, your body does not make or
use insulin well. Without enough insulin, the glucose stays in your
A blood test can show if you have
diabetes. Exercise, weight control and sticking to your meal plan can
help control your diabetes. You should also monitor your glucose level
and take medicine if prescribed.
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