People with type 1 diabetes (T1D) are at higher risk of experiencing bone fractures and breaks.
Long associated with declining bone mass in older age, people with T1D find themselves at greater risk of broken bones and longer recovery times at a younger age than the general population. One study reported as much as a sevenfold increased risk of hip fracture in people with T1D who are between 20 and 60 years old.
As with any injury, diabetes can delay or disrupt recovery with slow healing or complications. High blood sugar, or hyperglycemia, is a common experience in diabetes that can interfere with bone formation and healing. There are a number of other conditions associated with diabetes that are also associated with an elevated risk of broken bones. Not all of these relationships are completely understood.
Read on to learn more about why people with diabetes face a higher risk of broken bones and what can be done in response.
Diabetes slows the healing process. The immune system is disrupted leaving people with diabetes vulnerable to infection and other potential complications. Healing of a bone fracture may be prolonged by as much as 87 percent for people with diabetes, including a higher risk of healing complications.
A number of factors that are part of life with diabetes also mean a higher risk of broken bones.
The primary impacts diabetes complications have on bone health are twofold:
The diabetes complications most commonly associated with bone health are the following:
The reduced vision that comes with retinopathy, which is when blood vessels in the back of the eye are damaged, can lead to confusion and dizziness and a higher risk of falls and fractures.
Additionally, loss of sight can lead to the person feeling less confident about their physical movement overall. In response, the person reduces their movement and exercise leading to weakened bones and muscles.
In a Korean study, a “significant” association was found between the presence of diabetic retinopathy and the reduction of bone mass density and an increased presence of osteoporosis in women. This finding was significant enough that the researchers suggested that retinopathy might be considered a marker for reduced bone mass density. Interestingly, the same association wasn’t observed in men.
Nerve damage caused by neuropathy undercuts bone health in two ways: by causing more falls and by disrupting blood flow to bones. With neuropathy, the ability to feel sensations in the extremities and physical coordination are disrupted. Together, these increase the risk of falls and fractures. Additionally, neuropathy can disrupt blood flow to bones, interrupting the bodily processes that build up and maintain bone mass, resulting in bone weakening over time.
As kidney function deteriorates in nephropathy, the body’s ability to filter blood of waste and regulate hormones that control bodily functions diminishes. Both of these effects disrupt the normal mechanisms that build and maintain bone mass and strength. Over time, the body’s ability to repair bone mass and tissue is undermined.
While people with both main types of diabetes experience a higher overall risk to their bone health, important differences have been observed.
In those with T1D, there’s a higher risk of fractures at an earlier age. This is thought to be because changes in their bone mass seem to happen at a young age. Insulin is an anabolic agent for bones, meaning that it contributes to bone building, and so a deficiency of insulin contributes to low bone formation.
The increase in risk to bone health for people with T2D is associated with how long they’ve had a diagnosis and how much insulin they use. The longer they experience hyperglycemia, the more likely they are to show signs of bone weakening.
For both types, hyperglycemia may contribute to bone fragility by producing more AGEs along with oxidative stress. Both of these factors are associated with a reduced rate of bone formation.
Yes. Traumatic injuries, such as breaking a bone, can lead to stress hyperglycemia. This effect can be present with or without diabetes. Since hyperglycemia can lengthen and undermine recovery blood glucose levels need to be closely monitored and managed when recovering from a broken bone.
Most broken bones are immobilized with a cast or brace. This will limit your ability to move and use the broken part of your body.
Follow a doctor’s orders and take the time to rest and heal. You’ll most likely be told to rest and avoid putting weight or stress on the broken bone.
If there are any symptoms of a complication (swelling, odd sensations such as heat or numbness, bleeding, etc.) get care immediately.
There are a number of things you can do to improve your bone health.
Bone health is yet another aspect of the body that can be adversely affected by diabetes. This is because of the medications, including insulin, as well as diabetes-related complications that lead to a higher risk. Many of the things suggested to keep bones healthy and strong dovetail easily with things people with diabetes are already advised to do to manage their overall health, including glucose level management, eating balanced meals, and regular exercise.
Last medically reviewed on May 25, 2022
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
May 25, 2022
Corinna Cornejo
Edited By
Mike Hoskins
Medically Reviewed By
Megan Soliman, MD
Copy Edited By
Christina Baswell
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