Diabetes is a common disease among middle-aged and elderly people. In addition to the typical symptoms of polyphagia, polyphagia, polyuria and weight loss, it is often accompanied by osteoporosis. It is also often accompanied by osteoporosis. According to statistics, about half of the diabetic patients suffer from osteoporosis.
Due to the high blood glucose concentration in diabetic patients, the kidneys excrete too much glucose and increase calcium excretion, resulting in a large amount of calcium loss in the urine over time.
The large amount of calcium loss in urine leads to lower blood calcium. When blood calcium continues to decrease, the parathyroid glands are stimulated by calcium deficiency for a long period of time and may become hyperfunctional secondary to excessive secretion of parathyroid hormone, which leads to increased osteoclast activity and freeing of calcium from bone tissue into the bloodstream, resulting in “calcium migration”. In diabetic patients, calcium is excreted in large quantities, and phosphorus and magnesium are also lost from the bones. Low magnesium also stimulates parathyroid secretion. In addition, in addition to impaired glucose metabolism, diabetic patients also have dysregulation of vitamin and calcitonin metabolism, which affects bone metabolism and induces osteoporosis. On the contrary, if the blood sugar is well controlled and the patient does not have symptoms such as excessive drinking and polyuria, it will not lead to a large loss of calcium.
Insulin is not only crucial for glucose metabolism, but also affects the synthesis of proteins. Bone is made of protein (collagen) as a matrix and a large amount of calcium deposited on top. Insufficient collagen synthesis and reduced bone matrix in diabetic patients also aggravate osteoporosis.
In addition, the daily calcium intake of our residents is low, coupled with the strict control of diet and lack of attention to calcium supplementation in diabetic patients, the low blood calcium level is likely to cause diabetic osteoporosis.
Osteoporosis is one of the comorbidities of diabetes mellitus, most of which starts slowly and lasts for several years. The main clinical manifestations are back pain, finger twitching, gastrocnemius muscle spasm, brittle and bendable bone joints, and even deformities such as back bending and hunching, limping, etc. X-ray examination reveals a decrease in bone density. The resistance of diabetic patients is reduced, and if femoral neck fracture and lumbar spine fracture occur again due to osteoporosis, they will be bedridden for a long time, which in turn will cause bed sores and infections. If not handled properly, the patient’s health and life can be greatly threatened.
Therefore, diabetic patients must be alert to osteoporosis. It is important to pay attention to the presence of symptoms such as low back pain, as well as to measure blood calcium and urine calcium, or to measure bone density with a bone densitometer, for early detection and early treatment.
The prevention and treatment of diabetic osteoporosis is firstly to actively control diabetes, followed by a balanced diet, calcium and vitamin D supplementation, and appropriate outdoor activities. If osteoporosis is more severe, medication should also be applied.
How should calcium be supplemented? The first thing is to make good dietary adjustments. The best source of calcium in food is dairy products, which are not only rich and highly absorbed, but also convenient to consume, and are the best food source of calcium. 100 ml of milk contains 100 to 120 mg of calcium. It is recommended that diabetic patients drink 1 to 2 cups of milk (200 to 250 ml each) daily. Bone broth for diabetics is not a good source of calcium, and it also brings about the problem of excess fat, which is something we should be aware of.
Beans and seafood such as seaweed and nori are also rich in calcium. Mushrooms, hard fruits and oil seeds such as almonds, melon seeds, walnuts and sesame paste contain a certain amount of calcium, for example, 100 grams of almonds contain 62 mg of calcium; 100 grams of sesame paste contain about 1100 mg of calcium.
Vitamin D is required along with calcium supplementation
The recommended daily requirement of calcium for normal people is 800 mg, and for elderly people, 1000 mg. In fact, people get only 500 to 600 mg of calcium from food daily. Therefore, calcium supplements should be taken appropriately. In the case of diabetes, more calcium supplementation is needed because of more calcium loss.
It is important to remind that vitamin D should be taken along with calcium supplements and that you should go outside to get more sunlight. Vitamin D can promote the absorption of calcium and phosphorus in the small intestine and increase the concentration of calcium and phosphorus in the blood to facilitate the formation of calcification and ossification of class bones. Some calcium preparations (such as Calcium D) contain not only calcium but also vitamin D. Therefore, it is not necessary to take such calcium preparations to supplement vitamin D.
The following are two recommended dishes high in calcium.
1, mushroom tofu stew
main ingredients: 400 grams of southern tofu, 50 grams of mushrooms.
Ingredients: 25 grams of bamboo shoots.
Seasoning: sesame oil, soy sauce, salt, a little monosodium glutamate.
Practice: (1) tender tofu cut into small pieces, put into a pot of cool water, cooked over high heat, see the tofu honeycomb, fish out.
(2) tofu add bamboo shoots, fresh mushrooms, soy sauce, salt and soup (soup added to submerge the tofu is good), move to a low fire stew for about 20 minutes.
(3) Add MSG and sesame oil to start.
Note: This dish can be replaced by shrimp mushrooms, called “shrimp stewed tofu”, when eating can be sprinkled with minced cilantro, also very tasty. Do not use or less starch to thicken the soup.
Nutrition: contains 21 grams of protein, 25 grams of fat. Calories 410 kcal, containing calcium 970 mg.
2.Tomato soybean
Ingredients: 100 grams of soybeans, 50 grams of tomato paste.
Ingredients: bamboo shoots 25 grams.
Seasoning: big spice, pepper, a little, MSG, salt, 5 grams of cooking oil.
Practice.
(1) soybeans soaked for 20 minutes, clean, into the pot with additional ingredients, pepper water, monosodium glutamate, salt and water to cook, soup to taste.
(2) frying pan on a high fire, add a little cooking oil, add tomato sauce, soybeans, add water thin gravy appropriate amount, wait for the juice to close can be served.
Features: fresh and crisp.
Nutritional composition: contains 37 grams of protein, 511 kcal, 372 mg of calcium.