Insulin is the hormone secreted by the pancreas in response to blood sugar which reduces the blood sugar and helps the cells to absorb it for fuel. Insulin can also be injected in individuals who suffer from diabetes when their bodies do not secrete enough insulin for their individual needs.
People who suffer from type 1 diabetes need insulin because their pancreas has completely stopped producing the hormone. This type has some links to viral infection and is not related to obesity or diet. People who suffer from type 2 diabetes will first experience insulin resistance, where the body secretes insulin but the cells can no longer use it. This often happens in individuals who are overweight or obese and whose bodies must produce insulin consistently to accommodate the amount of blood sugar.
At some point in the natural progression of the disease, the pancreas can no longer produce enough insulin to accommodate the body’s needs and blood sugar rises precipitously.
Researchers have found that individuals who suffer from type 1 diabetes have a lower bone density and a much higher risk of osteoporosis and fracture. Bones will normally become weaker with age as the body reabsorbs more bone than it produces as we get older. However, there are other risks that will increase this process, such as a low body mass index, alcohol, smoking, Cushing’s syndrome and type 1 diabetes.
Although researchers do not yet understand the mechanism behind the reduced bone mass density, individuals with type 1 diabetes may experience great loss of bone density because of the use of external insulin. Researchers have also found that although people with type 2 diabetes have a higher bone mass density, they are also at increased risk of suffering bone fractures.
Another study using Rosiglitazone, an insulin-sensitizing drug, found that individuals using the medication to reduce insulin resistance suffered decreases in their bone quality and an increase in porosity. This means that the bones became more porous over time, especially in the long bones of women. (1)
Researchers have also determined that insulin resistance, namely hyperinsulinemia – or too much insulin in the blood stream – is responsible for reduction of the strength in the femoral neck. The femur is the long, large bone in the upper leg that connects to the hip. That ball and socket joint is the position of the femoral neck. (2)
Competing research published in the American Journal of Physiologic Endocrinology Metabolism identified insulin as an anabolic agent that more commonly increased bone density in type 2 diabetics. (3) However, density of the bone is not necessarily related to strength if the bone that is formed is not formed correctly.
Then in 2013, research was presented to the Endocrine Society’s 95th Annual Meeting and later published which showed that insulin resistance is associated with weaker bones. (4) So, while some researchers believe that insulin helps to strengthen bone, it has been confirmed that hyperinsulinemia – or too much insulin in the blood – has the opposite effect and will weaken the bone structure.
References:
(1) Diabetes Journal: Effect of Rosiglitazone on Bone Quality in a Rat Model of Insulin Resistance and Osteporosis
http://diabetes.diabetesjournals.org/content/60/12/3271.full.pdf
(2) Journal of Bone and Mineral Research: Insulin resistance and bone strength
http://www.midus.wisc.edu/findings/pdfs/1314.pdf
(3) American Journal of Physiology and Endocrinology Metabolism: Is insulin an anabolic agent in bone
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387001/
(4) Endocrine Society: Insulin Resistance Linked to Weaker Bones
http://www.sciencedaily.com/releases/2013/06/130617110715.htm
Resources:
Diabetes UK: Osteoporosis and Diabetes
http://www.diabetes.co.uk/conditions/osteoporosis-and-diabetes.html
NIH Osteoporosis and Related bone Diseases: What people with diabetes need to know about osteoporosis
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/diabetes.asp
Medscape: Link between diabetes and osteoporosis
http://www.medscape.com/viewarticle/465736
Clinical Diabetes: Osteoporosis and diabetes
http://clinical.diabetesjournals.org/content/20/3/153.full
Annals of Endocrinology: The Relationship between insulin resistance and osteoporosis in elderly male type 2 diabetes mellitus and diabetic nephropathy
http://www.ncbi.nlm.nih.gov/pubmed/23122575
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