Bones of diabetic people more fragile: PGIMER experts

Diabetic people experience increased fragility in bones, leading to a higher risk of recurring fractures, said health experts at PGIMER, Chandigarh, on World Diabetes Day that falls on November 14 annually.

This year, the theme of World Diabetes Day is “Prevention of type 2 diabetes”.

Head of PGIMER’s endocrinology department, Dr Sanjay Bhadada explained that diabetes affected every organ in the body, including both soft and hard tissues. Describing bones as the “steel” of the human body, he emphasised that bones in diabetic individuals tended to be more fragile.

Despite the necessity for strong bones, the elasticity of bones in diabetic patients was heightened, posing an increased risk of fractures, the professor said.

To know why bone health deteriorates in diabetes, the departments of endocrinology and orthopaedics, PGIMER, and IIT Ropar jointly conducted a study.

For this, they collected bone tissue from neck of femur of 70 hip fragility fracture patients — 40 without diabetes and 30 with diabetes. All these patients either underwent bipolar hemiarthroplasty or total hip replacement.

The research was published in “The Journal of Clinical Endocrinology & Metabolism, 2021”.

The study evaluated macro to nano structure-level bone health by using micro CT, nanoindentation, bone composition, elasticity and modulus.

Dean, research, IIT Ropar, Navin Kumar said as per the study’s findings, type 2 diabetes (T2D) affected bone homeostasis leading up to three-fold increased hip fracture risk compared to those without diabetes. This high fragility fracture risk was observed despite adequate areal bone mineral density (aBMD) in T2D .

Replacement surgery was the recommended treatment, as these hip fractures were unsuitable for management with cannulated cancellous screw or proximal femoral nail. Patients’ age also favoured replacement surgery for better outcome. T2D was diagnosed according to the American Diabetes Association criteria (24).

Patients with cancer, osteoarthritis, renal dysfunction, primary or secondary hyperparathyroidism, unexplained elevated alkaline phosphatase and secondary osteoporosis (chronic steroid or antiepileptic use) were excluded from the study.

Dr Bhadada further highlighted that diabetes was on the rise among the youth, attributing it to a shift in lifestyle characterised by reduced physical activity and altered eating habits.

Additionally, heightened awareness has led to increased testing, resulting in a higher number of individuals testing positive for diabetes.