Cells called osteoclasts break down bone while another type of cell, osteoblasts, build it up. The mechanism for bone remodeling is complex and not completely understood, but one of the molecules involved is sclerotin, which is thought to inhibit osteoblasts from doing their job.

Osteoporosis, or brittle bone disease, is responsible for bone fractures in both older people and people diagnosed with Type 2 diabetes. Although diabetics tend to have less mineral mass in their bones than non-diabetics, mass is not the only factor affecting bone strength. The architecture of bones is as important as the mass, and the Study of Osteoporotic Fractures found that women with Type 2 diabetes had a higher rate of fracturing their hips, thighs, and feet than did non-diabetic women. Osteoporosis tends to be more common in diabetics with poorly controlled blood sugar levels, than in those with good control.

Researchers at the University Hospital of San Cecilio in Granada, Spain, guessed that sclerotin might be higher in uncontrolled diabetes than in healthy individuals and designed and carried out a study to test their idea.

This Study: Their study, published in the Journal of Clinical Endocrinology and Metabolism, in October 2011, included 74 volunteers with Type 2 diabetes and 60 healthy participants. Sclerostin levels were significantly higher in diabetics than in non-diabetic participants. The highest levels of sclerostin were found to in those who had diabetes the longest, and in those who had the highest levels of hemoglobin A1c.

Studies are underway to treat osteoporosis by using antibodies against sclerotin. In the mean time, controlling Type 2 diabetes could be one way of keeping sclerotin within normal limits. With good diabetic control, your hemoglobin A1c (HbA1c) should be 7 per cent or less.

Osteoporosis is a disease that often goes unrecognized until there is a fracture. Several tests are available to monitor bone density and architecture, and they should be discussed with your doctor. Type 2 diabetics sometimes fall because of:

    * neurological damage,
    * poor coordination,
    * poor sensation,
    * pain in the feet, and
    * poor eyesight...

all of which should be addressed to prevent bone fractures.

Getting enough calcium, vitamin D and exercise can all help to keep your bones strong. Take good care of your bones so they can take good care of you.

By Beverleigh H Piepers