Osteopenia and osteoporosis in diabetics

1

Well, I just had a DXA bone scan today, which they recommend every 2 years for all men over 70 and women over 65, but younger, if you have risk factors. And I found out that Type 1 in particular is considered a risk factor. I'm 63, but I guess I count as having a risk factor.

Turned out that I have osteopenia (low bone mineral density, but not as low as in osteoporosis) in the femurs, but not in the spine. That surprised me, because I haven't had diabetes as long as some (It started at age 43 and I was formally diagnosed at 45), and osteoporosis doesn't run in my family. :-(

The risk factors include normal to low BMI, thin bone structure, smoking, auto-immune diseases, excessive drinking, not enough calcium and vitamin D in bone-forming years, family history, history of anorexia (diabulimia!) and inactivity.

So there is definite evidence that women (but also men) with Type 1 are at increased risk, and osteopenia is a risk factor for osteoporosis. One article said that 50% of Caucasian women will break a bone at some point in their lives.

But the really surprising fact is that, although Type 2 women tend to have INCREASED bone mineral density, at least partly attributable to the fact that their bones get more weight-bearing exercise, they are also at increased risk of fractures. And no one knows why.

I also read up on treatment, and there is no general consensus there. On the one hand, taking drugs like bisphosphonates and other drugs could actually increase bone mass to some extent, but in osteopenia, the person might never experience a fracture anyway, and why take a drug that may not be needed? Osteoporosis, being more severe, with a higher risk of fracture is another story, but again, the question is why wait until you are at great risk?

So I'm going to continue reading up about it, and going to delay making any kind of decision until I have a chance to talk with both my PCP's APN, and my Endo's APN -- I'm taking enough drugs as it is, and since all the available drugs have unpleasant side effects, I'm not going to rush into anything. But I would be interested in any insight any of you may have! :-)

2

Natalie, 2 Caltrate a day + a bisphosphate once a week may save you from losing height and having excruciating pain as the spine shortens. The fact that these don't run in your family is great; maybe you won't see progression. Looking around at others my age, 82, makes me think a LOT of women have progression. In fact, I am starting to stand out as the tallest of my cohort. Maybe the question will be, do you have arthritis or an autoimmune disease in your family? Might tip the scale in favor of the calcium and bisphosphates.
My insight comes from having taken these for many years prior to having diabetes and 17 years later, not having lost a bit of height. In my case, diabetes didn't seem to make any difference. I had osteopenia back when I was 65 before T1.

3

No arthritis, and no autoimmune disease in my family (except possibly my maternal grandmother, but I don't know for sure)! I'm the one who got the autoimmune issues out of nowhere! However, I still have no signs of arthritis.

I just checked my usual calcium intake of milk and yogurt, and it comes to about 75% of daily needs according to the labels, and there is another 22% in the multivitamin I take, which adds up to 97%. I wonder if I should supplement with a little more calcium. My vitamin D intake is good, and I tested normal, albeit low-normal, on my last test.

So you've given me the idea that I should read up on calcium and vitamin D supplementation! Thanks! :-)

4

I'd like to just say three words.

Magnesium

Vitamin D

Weight Training

Opps, that wasn't three words.

5

I like Citracal Plus, which contains both Vitamin D3 and magnesium.

6

Osteoporosis runs in my family; it can get to make you look like a camel. My mother shorten up two inches quickly after menopause. I already got the osteopenia, so I just take at least 1200mg worth of calcium in my food everyday and vitamin D for the days I'm not out in the sun.

I don't really have a lot of faith it's going to make the condition disappear. And if this doesn't make it disappear, why would we think other meds would? I think the goal of those meds is to keep you from getting worse, and you won't know what more worse you'd be if you didn't take them.

Another thing, if you are gonna do high protein diet, low carb fiber and calcium pills, you will plug up for sure. This doesn't encourage me to keep taking my pills.

7

Three words, picklebird: psyllium husk capsules. Or one word: metamucil.

8

Diagnosed osteopenia at the age of 50. Doctor advised to take calcium and vitamin E suppliments in addition to consuming whole dairy products daily. The only other insight I have is my mother's experience diagnosed with osteoperosis, by increasing her calcuim and vitamin D the osteoperosis has been downgraded to osteopenia. I think she is also taking the drug for women that is often perscribed, although the name escapes me now.

9

Hi Natalie~
I'm new to Tu and don't know how it works at all, but I was drawn to your bio after reading the above. What a surprise! I, too, was diagnosed in 1993 (my first shot was on my 50th bday... happy birthday, Cindy!). Even tho I have 2 sons who were diagnosed Type 1 as children, I went thru the same pill swallowing type 2 routine you did! But it wasn't long b4 I joined Steven and Mark in Insulinville.
I've only been a pumper since August and I'm looking forward to some comraderie now that I've found Tu. I need to learn how to navigate it first.
Nice to meet you Sister!
Cindy
p.s. oh yes... hyperthyroid too. :-)

10

I was diagnosed with osteopenia about five years ago and am on my final year of taking Fosamax. My internist wanted to stop the downward trend of my bone density compared to normal. The Fosamax has done that. It is not a drug that you should be on forever, and I think that five years is what my internist said.



I am caucasian, thin, and type 1 diabetic. All are risk factors for osteoporosis. My mother was never diagnosed with osteoporosis but she was quite hunched over as she aged. So although the risk factors for taking Fosamax are a bit scary, they are rare. I also take supplemental calcium as calcium citrate. I’ve never had a bone fracture as an adult. I do have an inflammatory type of arthritis in addition to osteoarthritis, so I have some increasing disabilities due to this. I am 59 years old and had had Type 1 for 35 years.



I have no real advice. I have chosen to follow my doctors’ advice on all of this stuff. So far I’m doing fine, so for me I think this has been a good decision. My bone scans have improved and I’ve had no side effects.

I’ve always tested normal for Vitamin D. My calcium citrate tabs do include Vitamin D as does my daily vitamin. But I’ve never taken any other Vitamin D supplements.

11

In my case, osteoporosis does NOT run in my family. NONE of my aunts or mother or grandmothers had it, so far as I can tell; none of them were hunched over, and none of them had fractures. But none of them had any autoimmune disorders, either, so far as I know.

So I think I'm just going to take care of keeping my Vit. D levels normal, and consuming enough calcium. I don't think I'm in the place where I'd need Fosamax or any other drug. If my bone density deteriorates later on, I can always rethink it. Thanks for your input! :-)

12

Do you drink coffee? I was diagnosed with osteopenia many years ago and was taking Fosamax, and drinking lots of coffee. Then after reading so much about coffee leaching calcium from bones, I stopped drinking it. My next dexascan showed that I have normal bones without any osteopenia!!! No more Fosamax. I also eat a vegan diet so no dairy products but I do suppliment with calcium, magnesium, Vit D. Worked for me.

13

I don't drink coffee, but I do drink black tea. But from what I can tell, there isn't much caffeine in tea. On the other hand, there IS theobromine, but I don't know if it has the same effect. I really appreciate all the responses I've gotten here -- all the more to think about! :-)

14

Hi Brian,

I just stumbled across your post. I do know it is a very old post but I do know you’re very active on the site as well. Is there a particular brand you recommend catered to Diabetics?

Thanks so much

15

Umm, not really. I think any reasonably well informed choice would be fine.