Diabetes and Bone Density

If you have diabetes, you may know the relationship between diabetes and bone density. As it turns out, recent studies have actually shown a correlation between diabetes and bone fractures. So what are these studies telling us about diabetes and bone density? 

Interestingly, even though better Bone Mineral Density (BMD) scores would seemingly indicate a lower risk for fractures, someone with diabetes can have a better BMD score and still be at higher risk for bone fractures. 

Women with Type 1 diabetes are 12 times more likely to experience a fracture than non-diabetics. That’s significant! And the longer you’ve had diabetes, the higher your risk. 

According to bone expert Dr. Susan E. Brown of Better Bones, “a recent systemic review of 16 studies confirms that those with type 2 diabetes have nearly three times the risk of hip fracture as age-matched non-diabetics. Persons with type 1 diabetes fare even worse, having more than a 6-fold increased risk of hip fracture as they age.”

So, it’s apparent that diabetes weakens the skeleton in ways other than decreasing bone density. This condition has been given the name diabetic osteodystrophy, a topic of concern for us at StrengthX, where we take bone health very seriously!

What makes people with diabetes at higher risk for fractures?

While the mechanisms are not defined, some findings give us clues as to why people with diabetes are at higher risk for fractures than non-diabetics, even when they have similar or even better BMD scores.

First, it seems the bones of diabetics are more porous than non-diabetics. The more porous the bone, the more prone it is to fracture. It has been known for some time that bone resorption decreases when insulin levels are high (which occurs in type 2 diabetics). (Bone resorption is the process through which bone material is broken down so minerals can be used for critical bodily functions). This finding shows that the turnover (production of new bone material) is slowed when insulin levels surge. This could be the reason for increased bone porosity in people with diabetes.

The other key point is that chronically high blood sugar has a detrimental effect on collagen production, thus compromising the organic part of the bone matrix. This could explain why this measure of bone quality (strength of the organic/collagenous part of the bone matrix) was significantly lower in diabetic patients than in non-diabetics with similar BMD scores.

High blood sugar can also cause oxidative stress, which increases inflammation in all the body’s tissues, including the bones. Inflamed tissues are compromised tissues.
Another factor that can play a role in compromised bone health is sub-optimal levels of vitamin D. It is a nutrient in which many people with diabetes are deficient. Learn more about the benefits of vitamin D in this previous blog post.

How can people with diabetes maintain healthy bones?

So let’s discuss what you can do to keep your bones healthy and reduce your risk of bone fracture if you have Type 1 or Type 2 Diabetes.

The first thing to remember is what we already mentioned: BMD scores for diabetics can be misleading. If you have a “healthy” BMD score, keep in mind that other factors influence bone strength in diabetic patients. 

Lifestyles that promote healthy bones include a few essential habits and behaviors. 

One essential factor is maintaining a healthy diet. Sugar is not suitable for anyone, even non-diabetics. And one of the reasons for that is that it leaches minerals from the bones. 

Other dietary factors include eating an alkaline diet, which means eating lots of vegetables, legumes, whole grains, nuts, and seeds (preferably organic) and lean meat.

Have your vitamin D checked as well! Learn why vitamin D is an essential nutrient for bone health here.

And last but not least, the method we’re most passionate about here at StrengthX makes sure you are engaging in regular osteogenic loading exercises. Don’t know what that is? Check out our previous blog posts to learn more about it (linked below). 

How to Improve Bone Health Using the Wisdom of Wolff’s Law

What Bone Density Experts Know About Osteogenic Loading

Osteogenic loading is one of the best ways to maintain bone density (and overall bone health), and at StrengthX, we make it fun and easy!


There’s an unexpected relationship between diabetes and bone density. It’s that even though people with diabetes may have good BMD scores, they are still more prone to fractures than people who don’t have diabetes.

There are several reasons this is the case, and they are all related to the effects of sugar and insulin in the body. If you have diabetes, paying particular attention to your bone health is essential.

Taking care of your diet (eating alkaline foods and avoiding sugar) is one way to keep your bones healthy. Still, it’s super important not to overlook the necessity for regularly engaging in osteogenic loading activities. That is our specialty here at StrengthX, and we love helping people build and maintain healthy bones the fun way!