AGEs: Why diabetes is bad for your bones

Diabetes comes with a long list of complications that affect so many parts of the body — including the brain, heart, eyes, feet and kidneys.

These complications don’t happen to everyone with diabetes. But the longer you have the disease and the worse your blood sugar control is, the more likely you are to eventually develop one (or more) of them.

Why does diabetes impact so many different organs and systems in your body?

Because the excess sugar can damage the body in a multitude of ways:

• It can damage the walls of tiny blood vessels known as capillaries that supply blood to your nerves, particularly in the legs, and lead to nerve damage.
• It can damage the filtering system in the kidneys that removes waste from the blood, eventually triggering kidney failure.
• It can damage the blood vessels of the retina, causing vision problems or even blindness.

And that damage can extend to your bones as well…

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Diabetes puts you at risk for hip and other debilitating fractures

Researchers from the University of Sheffield reviewed health records from previous studies and determined that people with diabetes (type 1 and 2) have a higher risk of developing hip and non-vertebral fractures (fractures that don’t impact the spine or skull).

Like other diabetes complications, researchers found that the risk of bone fractures was higher for people who had the disease longer and those whose blood sugar control was worse. The risk was also higher for those with type 1 diabetes versus those with type 2 diabetes. But people with type 2 diabetes who used insulin had a higher risk too.

Even though bone fractures aren’t on most people’s radar as a possible diabetes complication, this isn’t the first study to show people with diabetes have a higher fracture risk…

• A 2014 study found that people with diabetes are as much as three times as likely to get a bone fracture as people without diabetes.
• Another from 2018 found women diagnosed after age 40 with diabetes experience a 30 percent increase in their risk of non-vertebral fracture and an astonishing 82 percent increased risk for hip fracture.

Hip fractures, in particular, are known to cause disability in older people and even increase the risk of dying within a year of the injury.

What’s the connection between diabetes and poor bone health? Advanced glycation end-products (AGEs).

AGEs are associated with elevated fracture prevalence or incidence, in particular among people with diabetes.

AGEs cause oxidative stress and inflammation. They also physically affect bone quality when they accumulate in bone collagen fibers. A growing body of evidence indicates that AGEs play a significant role in the progression of classical diabetes complications and diabetic osteopathy.

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Better controlled blood sugar for better bones

So, how do you protect your bones if you have diabetes?

First, you have to do everything in your power to keep your blood sugar under control. For many people with diabetes, that means using diabetes medication, exercising regularly and eating a healthy diet.

Avoid foods that contain AGEs. Meat contains 150 times more AGEs than fruits and vegetables, so switching a meaty meal to a vegetarian meal a few times per week is one of the best ways to lower your AGE intake.

When you do eat meat, avoid grilling, roasting, searing, frying or baking. These cooking methods, which use high heat for long periods, increase the amount of AGEs produced in the meat. Wet cooking methods like steaming, poaching, stewing and boiling result in lower AGE production.

Snack on berries. One in particular, the Aronia berry, also known as the chokeberry not only helps lower the amount of sugar entering your bloodstream after you eat but is the highest berry source of chlorogenic acid (CGA) — an antioxidant compound that has been found to not only decrease bone loss but promote bone growth.

Next, you may have your doctor check your vitamin D levels. Why?

• According to McMaster University, many people with diabetes are
  low in vitamin D.
• Another study found that people with vitamin D blood levels of 50 ng/mL (considered adequate) were five times less likely to develop diabetes than those with 20ng/mL. The lead author of that study suggested that rather than focusing solely on obesity and sugar and fat intake, we should be focusing on vitamin D levels.

And not only is vitamin D known to help regulate insulin levels, we already know it helps promote bone health.

Sources:

1. People with diabetes at higher risk of bone fractures — co.uk.
2. People with diabetes are at greater risk of bone fractures —  EurekAlert!
3. Advanced glycation end products and bone — Science Direct.com
4. The risk of hip and non-vertebral fractures in type 1 and type 2 diabetes: A systematic review and meta-analysis update — Bone.
5. Diabetes — Mayo Clinic.
6. Bone Fractures: Prevention — Cleveland Clinic.