Type 2 Diabetes Compromises Bone Elasticity

There are many complications associated with type 2 diabetes (T2D), including impaired cardiovascular and kidney function, as well as an increased risk for bone fractures. Until recently, it was unclear exactly why bone fractures were common among patients with T2D.

New findings suggest that T2D impacts the collagen in the bones, which results in diminished bone flexibility, according to a study published by the Journal of Bone and Mineral Research.

Collagen fibers allow healthy bones to stretch and slide in response to strain in order to prevent them from cracking, according to the authors.

In patients with diabetes, hyperglycemia results in the build-up of advanced glycation end products, which bind collagen fibers together and impair their flexibility, according to the study.

The researchers examined the bones from the lower back and forearm of lean, obese, and obese diabetic rats in the study. The investigators viewed high-resolution CT scans, tested the biomechanical properties of the bones, and measured how collagen networks respond to strain.

Using supercomputers, these factors were simulated to determine their role in bone strength, according to the study.

“The management of fracture risk is an important goal for the elderly,” said senior author Aaron Fields, PhD. “Adults with type 2 diabetes have a higher fracture risk for a given bone density, which is otherwise the main clinical predictor of fracture risk. This is a widespread and growing issue now that these individuals are living longer with better insulin management.”

By comparing the obese rats to the obese rats with diabetes , the authors were able to determine bone complications from hyperglycemia.

The results showed that both obese rats and obese rats with T2D had weak bones.

Structural deficits, such as changes to the microarchitecture of the bones and inefficient bone mass distribution, were found in the obese rats and resulted in the overall weakening of bones, according to the study.

The authors found that obese rats with diabetes also had these structural deficits. Additionally, these animals had damage to the collagen network.

In the forearm bones in particular, collagen changes resulted in a significant decrease in the elasticity of bone tissue, according to the study.

The authors noted that the rats included in the study did not have long-term diabetes. They hypothesize that that increasing the duration and severity of diabetes would only further impair bone strength, according to the study.

“Our findings shed light on why bones in a diabetic milieu are so fragile,” Dr Fields said. “And in doing so, may lead to better diagnostic tools and therapies for managing fracture risk in adults with diabetes.”