The immediate cause of type 2 diabetes is often a condition called insulin resistance, in which insulin is present—produced as usual within the pancreas and released into the blood stream—but the cells don’t properly respond to it. Normally, insulin regulates the blood sugar, giving cells energy by moving glucose into them, but an insulin resistant cell turns away much of the glucose delivered by the insulin. With no where else to do, the glucose stays in the blood. Insulin resistance is what’s called a pre-diabetic condition, because it functions as a warning sign for incipient type 2 diabetes. In addition, insulin resistance itself is a risk factor for high blood pressure and heart disease.
Now another condition has also been linked with insulin resistance. Researchers have now found evidence people who have insulin resistance are more prone to bone loss and have weaker bones than subjects whose insulin operates normally. In fact, on average, as insulin resistance goes up, bone strength goes down—as much as 14 percent for each doubling of resistance. One reason for this is that insulin resistance is a precursor to diabetes, and diabetes is well-known to cause bone loss, but insulin resistance is associated with osteoporosis on its own.
This is particularly important news for women, people with white or Asian background, older people, or people with small frames, all of whom are at particular risk. People with a family history of osteoporosis also should be careful. People at risk for osteoporosis should avoid smoking, get enough exercise, and make sure to get plenty of calcium. Bone mass starts declining surprisingly early—sometimes before age 30—and the more you start with, the less likely you are to develop osteoporosis in the long run.
The usual treatment for osteoporosis involves medications called bisphosphonates which help restore calcium and hormone replacement therapy when drops in estrogen levels are identified as the culprit. Other medications can be injected in extreme cases where other approaches so not work.