Blood Sugar and Bone Health

The risks of elevated blood sugar are well documented and well known. However, there is another risk associated with high glucose—bone loss and impaired bone health. In those with Type-2 diabetes, the healing time for a fracture is 87% slower. High blood sugar impacts the cells that are responsible for bone health and healing.  The normal remodeling process of calcium regulation and bone building involves osteoclast cells that break down old bone and then osteoblasts which build new bone in its place.

When glucose in the blood is elevated, both osteoblast and osteoclast cells are inhibited, which means they are less able to aid in the remodeling of bone. There are also fewer of both types of bone cells in a person with diabetes. Elevated blood sugar for an extended period of time can also increase production of a particular factor in the body that increases osteoclast cell activity which dramatically increases bone break down resulting in weak bones.

Elevated glucose also decreases the amount of the hormone osteocalcin which stimulates bone building osteoblast cells. Studies suggest that osteocalcin also stimulates the insulin-producing beta cells on the pancreas, contributing to lack of blood sugar control.

Berberine was as effective as metformin in regulating blood sugar. A1C dropped from 9.5 to 7.5 in the berberine group.  There are now several new forms of berberine that increase the absorption and active time in the blood.

Osteocalcin production is stimulated by vitamin D and vitamin K.

Exercise also stimulates osteocalcin production and supports lower blood glucose levels.

Acta Biomater. 2019    Metabolism, 2008    Cell, 2007  Endocrinology, 2015