Prevention and treatment of bone diseases in diabetics

1. Skeletal Diseases in Diabetics Diabetes affects the musculoskeletal system by many poorly understood mechanisms. However, scientific data support an increased risk of fracture in people with diabetes. High blood sugar can increase urinary calcium excretion and inhibit bone formation. Decreased bone turnover with its properties of reducing non-mineralized bone matrix and increasing saccharification of collagen structures also leads to an effect on bone quality and an increased risk of fracture.
Bone density does not fully reflect the risk of fracture in patients with diabetes, especially type 2 diabetes. Bone density is usually low in patients with type 1 diabetes, but is normal in patients with type 2 diabetes. Corticosteroid porosity and changes in bone microstructure also affect bone strength in people with diabetes. At the same time, neurological diseases, retinopathy and cerebrovascular disease in diabetics also contribute to an increased risk of falls leading to fractures.
Factors that increase fracture risk include: advanced age, history of fracture, use of corticosteroid regimens, family history of a parent with hip fracture, low weight, smoking, excessive alcohol consumption , rheumatoid arthritis , secondary osteoporosis (eg in people with early menopause, chronic hepatitis, malnutrition, colitis...)

2. Prevention and treatment of bone diseases in diabetics 2.1. Healthy diet and lifestyle Healthy lifestyle with a diet high in fiber, beneficial fats, adequate calcium supplementation and vitamin D according to the advice of a nutritionist or doctor for each patient not only helps diabetics control their blood sugar well, but also reduces the risk of diabetes complications including musculoskeletal disease, diabetes, and diabetes. neuropathy, retinopathy, cardiovascular events such as myocardial infarction and stroke. Limiting sweet foods, including processed foods and beverages, and increasing the use of whole grains is a good habit in diabetics.
For women with postmenopausal osteoporosis, experts recommend a supplement of 1200mg of calcium and 800 units of vitamin D per day. For premenopausal women or men with osteoporosis, a daily supplement of 1000 mg of calcium and 600 units of vitamin D is recommended. Prefer at least half of calcium from the diet because supplements can cause more side effects, especially kidney stones.
Regular exercise, including weight-bearing exercises and proper stretching will also support your musculoskeletal system to be stronger. Weight maintenance or weight loss as needed is always recommended to reduce the burden on the skeletal system. You should quit smoking, avoid drinking a lot of alcohol, and take steps to prevent falls. Elderly people should be assessed for fall risk by healthcare professionals and optimally supported by their families in fall prevention.
2.2. Blood sugar control Optimal blood sugar control suitable for each patient will be discussed and advised by your doctor to ensure effective treatment and avoid hypoglycemia. Limiting frequent high blood sugar to reduce collagen glycolysis and reduce microvascular complications is important in protecting your bone health. Compliance with medication treatment and regular check-ups are the keys to optimal blood sugar control.

2.3. Evaluation and consultation by a specialist You should see your doctor regularly for optimal blood sugar control and to assess your risk of diabetes complications, including bone disease. When you have any unusual symptoms, even the mildest, you should immediately talk to your treating doctor during your visits for review and evaluation, as well as careful monitoring in the future.
In case you are taking drugs that can affect the skeletal system, your doctor will advise and keep the dose to the lowest effective dose and the shortest time to take the drug.
2.4. Medications Currently, the drugs used to treat osteoporosis in diabetics are similar to those in non-diabetics. On each specific patient, the doctor will evaluate, consider and choose different drugs. Before using the drug, your doctor will discuss and advise you.
Accordingly, you may be prescribed one of the drugs in the class of bisphosphonates or monoclonal antibodies or hormones and hormone regulators.
You should not arbitrarily use these drugs without being examined, evaluated and consulted by a specialist because all drugs can cause unwanted effects on your body. Follow the treatment when prescribed and follow the instructions of the doctor, pharmacist to avoid experiencing drug side effects. While taking the medicine, if you feel any discomfort or experience any abnormality, please consult your doctor for advice and timely corrective measures.
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