Medical expert shares ways to maintain muscle and bone health with diabetes

Did you know diabetes, which is a major cause of bone and joint problems, blindness, kidney failure, heart attacks, stroke and lower limb amputation, was the direct cause of 1.5 million deaths in 2019? And, most people don't even consider it a public health problem that the ability to approach epidemic proportions globally.

According to medical experts at Global Hospital, diabetes is a chronic disease characterised by elevated levels of blood glucose, which if untreated over time can cause damage to vital organs like the heart, blood vessels, eyes, kidneys and nerves. And, recent studies have shown that this chronic disease can also severely affect bone and muscle health, making them more prone to fractures.

According to research published in 2016, there is a 7-fold increase in hip fractures in patients with type 1 diabetes(T1DM). In type 2 diabetes(T2DM), this risk is increased by 1.3 times. Therefore, Dr Sneha Kothari says that it is extremely important for diabetic patients to take extra care of their bone and muscle health and prevent all the musculoskeletal discomforts associated with long-standing, uncontrolled diabetes.

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In an exclusive conversation with WION, Dr Sneha Kothari, Consultant Endocrinologist at Global Hospital, Mumbai, shared important tips to maintain bone and muscle health for diabetic patients. Read on!

How does diabetes affect bone health?

Our bones undergo continuous repair, says Dr Kothari. However, diabetics and lack of insulin levels in the body interfere with the formation of new bone leading to weak bone and muscle health. Other factors that attribute to poor musculoskeletal health are:

• Reduced release of insulin-like growth factor-1 (IGF-1)
• Poor absorption of calcium in the body
• Increased oxidative stress
• Increased glycation where sugar molecules bind to proteins and fats
• Loss of calcium in the urine

All these factors weaken the nerves (diabetic neuropathy), affect vision, and disrupt the normal mechanisms that build and maintain bone mass and strength thus predisposing a diabetic person to an increased risk of bone disorders.

Which bone diseases are more prevalent in diabetics?

People with long-standing and/or uncontrolled diabetes are more prone to:

• Osteoporosis: weakening of the bones due to low bone mineral density or poor bone quality
• Osteoarthritis: Wear and tear of the cartilage
• Frozen shoulder: A decreased range of motion of the shoulder
• Charcot joint: Severe degradation of joints and muscles due to nerve damage
• Diffuse idiopathic skeletal hyperostosis (DISH): Extreme pain and stiffness in the back or neck due to the hardening of tendons and ligaments that affects the spine
• Diabetic hand syndrome: Thickening or hardening of the skin on the hands leading to difficult finger movement
• Dupuytren’s contracture: Thickening of tissues beneath the skin of the palm and fingers leading to hand deformity

What can be done to maintain bone and muscle health with diabetics?

1. Include plenty of calcium in your diet: The Recommended Dietary Allowance (RDA) for calcium is 1,000 to 1,200 milligrams a day for adults. So, experts suggest that you include good sources of calcium like dairy products, almonds, broccoli, kale, tofu, salmon with bones, sardines etc, in your diet. In addition, one can also take calcium supplements.
2. Maintain adequate vitamin D levels: Vitamin D is needed to absorb calcium. For adults, the RDA of vitamin D is 600 to 800 international units a day. Good sources of vitamin D include fish (salmon, trout, whitefish, tuna), mushrooms, eggs and fortified foods, such as milk and cereals. Sunlight also contributes to the body's production of vitamin D. One can also take vitamin D supplements to meet the daily requirements.
3. Include physical activity in daily routine: Weight-bearing and strength training exercises like walking, jogging, swimming, squatting, push-ups, pull-ups, and lifting weights help to maintain blood glucose levels, increase stamina, improve bone density, and reduce the risk of diabetes-induced muscle disorders.
4. Modify lifestyle: Unhealthy lifestyle practices, like smoking and drinking increase the risk of bone and muscle disorders. Smoking reduces the body’s ability to absorb calcium from food. So, to improve bone health, diabetics must try to quit their unhealthy lifestyle habits.
5. Control blood sugar levels: By controlling blood sugar levels, one can prevent complications related to the disease.
6. Get body checkups regularly: People with long-standing and uncontrolled diabetes must get their bone density test done at regular intervals. It can help detect osteoporosis much before it affects their range of motion.