Type 1 diabetes was related with increased danger of occurrence of fracture that started in youth and stretched out over the life span. Type 1 and type 2 diabetes affect bone structure in different ways. That’s no small thing, as broken bones can lead to permanent disability. The association between diabetes and bone health has long been a matter of debate.
For type 1 diabetics, the risk of fracture was 39 percent higher when their average blood sugar levels over time were dangerously high than it was with lower blood sugar levels, the study found. Moderately high average blood sugar didn’t appear to impact the risk of fracture for these patients, however.
Researchers examined data on more than 47,000 people with diabetes, including 3,329 with type 1, the less common form, which typically develops in childhood or young adulthood when the pancreas can’t produce insulin.
“In patients with type 1 diabetes, it is important to have good glycaemic control, for almost everything and also to prevent fractures,” said Dr Francesc Formiga of Barcelona University.
“People with high levels of sugar should be aware that it is not good for their global health or for their bones and may increase the risk of fractures, therefore they should modify their treatment, according to the recommendations of their doctors,” Formiga said.
Diabetes has long been linked to an increased risk of fractures, but research to date has been mixed regarding exactly what role blood sugar levels play in this risk, Dr Christian Meier of University Hospital Basel in Switzerland and colleagues write in the Journal of Clinical Endocrinology and Metabolism.
Several complications of diabetes may contribute to an increased risk of falls and fractures including cognitive impairment; nerve damage (neuropathy) that diminishes sensation in the feet and other extremities; and retinopathy, or eye damage that makes it harder to detect obstacles that might cause a fall.
With type 1 diabetes, kidney failure was also associated with more than doubled odds of a fracture, the study found.
One limitation of the study is that researchers didn’t account for whether patients had diabetic neuropathy, said Dr. James Richardson, a professor in physical medicine in rehabilitation at Michigan Medicine in Ann Arbor who wasn’t involved in the research.
That factor might explain a lot of the accidents leading to bone fractures, he said.
“Fall risk is markedly increased in people who cannot successfully respond to a postural perturbation (such as a trip or slip, ankle turn) in the roughly 400 milliseconds available to do so,” Richardson said.
“This requires rapid and precise information that ‘reports’ the perturbation,” Richardson said. “This comes, primarily, from precise sensation in the feet and ankles and excellent visual acuity.”
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