People with diabetes have special challenges when it comes to bone health. Although scientists are still working to understand the complex relationship between diabetes and bone loss, it is increasingly apparent that high blood sugar levels damage bone tissue and alter bone chemistry in ways that leave them vulnerable to fractures. Type 1 diabetes is associated with low bone mineral density and increased fracture risk. Researchers have also identified an association between type 2 diabetes and increased fracture risk, even in people with normal or above normal bone mineral density. Although experts aren’t certain why people with diabetes experience more fractures, some speculate that people with diabetes may fall more frequently due to medication-related hypoglycemia (low blood sugar) or diabetes complications, such as impaired vision and nerve damage. In addition, there is evidence that diabetes may cause bone tissue changes that decrease bone strength without decreasing mineralization. Here are some things you can do to help protect your bones:

• Include minerals in your diet. Our bones need minerals, especially calcium, to be strong. Consider including nuts and seeds, green leafy vegetables, and low-fat dairy foods in your diet to boost your intake of bone-healthy nutrients. Discuss any diet changes with your healthcare practitioner first.
• Consider vitamin D. Vitamin D may help us maintain calcium in our bones. Many of us don’t get enough sun exposure to keep our vitamin D levels up all year, so consider taking 1,000–2,000 IU per day. Be sure to talk with your doctor before starting a new supplement regimen.
• Manage your blood sugar. Stick to a high-fiber, low-sugar diet, and follow your doctor’s advice about having regular blood tests to make sure that you are managing your blood sugar well and, if you take medications, that your dosages are right.
• Get physical. Physical activity not only improves blood sugar control, it also helps us build bone and avoid falls. Weight bearing exercises like walking, jogging, and dancing are great for keeping bones strong, and balance exercises like tai chi can reduce your risk of falling.
• Don’t smoke. Smoking increases your risk of osteoporosis, as well as diabetes complications like heart disease and nerve damage.

Source: National Institutes of Health