The clinical manifestations of type 1 diabetes and type 2 diabetes are inherently different
The clinical manifestations of type 1 diabetes and type 2 diabetes are different due to their different pathogenesis. type 1 diabetes mostly starts with ketoacidosis and absolute lack of insulin in the body, while type 2 diabetes mostly starts insidiously because of the presence of insulin resistance and insulin levels in the body are even higher than normal at the beginning of the disease.
The treatment plan for type 1 diabetes and type 2 diabetes is also different
Type 1 diabetes has to be treated with insulin since the day of the disease, while type 2 diabetes can usually be controlled by diet and exercise therapy first, then oral hypoglycemic drugs can be added when blood sugar is not well controlled, and finally insulin can be added or switched to control blood sugar. But, did you know? In fact, the difference between type 1 diabetes and type 2 diabetes is much more than that, the bone changes in these two types of patients are also different!
Bone lesion characteristics of type 1 diabetes
Both children and adults with type 1 diabetes have significantly decreased bone mineral content and bone density, even in those with normal growth and development.
There are various reasons for this.
1, mainly related to the absolute lack of insulin in type 1 diabetes, which is a hormone that promotes energy synthesis, and insulin deficiency can lead to loss of bone energy synthesis.
2, type 1 diabetes is more difficult to control blood sugar, and poor blood sugar control can lead to increased renal urinary sugar excretion at the same time excretion of more calcium.
3. type 1 diabetes is more volatile in terms of blood glucose and prone to hypoglycemia, which in turn can lead to an increased risk of falls and a high risk of fracture after a fall.
Type 1 diabetes is prone to microvascular complications, which in turn can lead to problems with the microcirculation supplying bone, resulting in bone “malnutrition” and so on.
Characteristics of bone lesions in type 2 diabetes mellitus
Most patients with type 2 diabetes are overweight or obese, a body type previously thought to be beneficial in the fight against osteoporosis. Imagine a person walking around with the equivalent of an extra 20 pound bag of flour or more per day, bones should be stronger. The results of bone densitometry are similar, with most type 2 diabetic patients having comparable or slightly higher bone density than normal people.
It is reasonable to assume that type 2 diabetes should not be a concern for bone problems, but it is not. In recent years, it has been found that type 2 diabetic patients are actually at high risk for fractures, although their bone density is OK. In other words, a type 2 diabetic patient with seemingly healthy bones is likely to have a fracture if he or she accidentally falls in the street.
There are many causes of bone problems in type 2 diabetic patients, such as diabetic microangiopathy; increased production of inflammatory factors due to obesity, and certain inflammatory factors may affect bone formation; certain glucose-lowering medications may also affect bone metabolism, such as clinical studies showing that thiazolidinediones may cause an increased risk of forearm fracture, etc.
In summary, type 1 diabetes and type 2 diabetes bone lesions are indeed different, so type 1 diabetes and type 2 diabetes in addition to the need for regular hospital checks of bone density and related indicators, but also need to do.
1. smoothly lowering sugar, which should neither be too high (otherwise it will cause increased urinary calcium excretion) nor too low (otherwise it will cause an increased risk of falls, which will lead to an increased risk of fractures), and in addition, smoothly lowering sugar can effectively delay the development of diabetic microvascular complications.
2. weight control (otherwise, increased production of inflammatory factors in the body will occur).
3. avoid certain glucose-lowering drugs if they are indeed also combined with other conditions that lead to an increased risk of fracture.
4. avoid falls.