The clinical manifestations of type 1 diabetes and type 2 diabetes are 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 insulin resistance and insulin levels in the body are even higher than normal at the beginning of the disease.
Type 1 diabetes and type 2 diabetes have different treatment plans
Type 1 diabetes must 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 the 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!
Third, the 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, insulin is a hormone that promotes energy synthesis, and insulin deficiency will lead to the 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 urinary glucose excretion of the kidneys at the same time excretion of more calcium;
3. Type 1 diabetes has high blood glucose fluctuations and is prone to hypoglycemia, which in turn can lead to an increased risk of falls and a high risk of fractures 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.
Fourth, the characteristics of bone lesions in type 2 diabetes mellitus
Most patients with type 2 diabetes are overweight or obese, and this body type was previously thought to be beneficial for the prevention and treatment of osteoporosis. Imagine a person walking around with the equivalent of carrying an extra 20 pound bag of flour or more every day, the 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, there is indeed a difference between type 1 diabetes and type 2 diabetes bone lesions, so in addition to regular hospital visits to check bone density and related indicators, type 1 diabetes and type 2 diabetes need to do the following.
(1) Steady glucose reduction, neither too high (otherwise it will cause increased urinary calcium excretion) nor too low (otherwise it will cause increased risk of falls and thus fractures), in addition, steady glucose reduction can also effectively delay the development of diabetic microvascular complications;
(2) Control body weight (otherwise increased production of inflammatory factors in the body will occur);
(3) Avoid certain glucose-lowering medications if you have other conditions that increase the risk of fracture;
(4) Avoid falls.