Type 1 diabetes is linked to low bone density, although researchers don't know exactly why. Insulin, which is deficient in type 1 diabetes, may promote bone growth and strength. The onset of type 1 diabetes typically occurs at a young age when bone mass is still increasing. It is possible that people with type 1 diabetes achieve lower peak bone mass, the maximum strength and density that bones reach. People usually reach their peak bone mass by age 30. Low peak bone mass increases one's risk of developing osteoporosis later in life. Some people with type 1 diabetes also have celiac disease, which is associated with reduced bone mass. It is also possible that cytokines, substances produced by various cells in the body, play a role in the development of both type 1 diabetes and osteoporosis.
Recent research also suggests that women with type 1 diabetes may have an increased fracture risk, since vision problems and nerve damage associated with the disease have been linked to an increased risk of falls and related fractures. Hypoglycemia, or low blood sugar reactions, may also contribute to falls.
Increased body weight can reduce one's risk of developing osteoporosis. Since excessive weight is common in people with type 2 diabetes, affected people were long believed to be protected against osteoporosis. However, although bone density is increased in people with type 2 diabetes, fractures are increased. As with type 1 diabetes, this may be due to increased falls because of vision problems and nerve damage. Moreover, the sedentary lifestyle common in many people with type 2 diabetes also interferes with bone health.
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