Posts Tagged ‘Bone Mineral Density’
Patients with poorly controlled Diabetes and high blood sugar levels often have bone with above average Bone Mineral Density (BMD). This is good? WRONG !!
High blood sugars lead to glycolization of the Bone Matrix, which is the protein part of the bone – collagen. This means that glucose (sugar) molecules are incorporated into the collagen protein chains. This distorts and stiffens the Bone Matrix.
Normally, stiffer is better, Calcium stiffens the bone matrix, which strengthens the bone. But too much of a good thing is bad. Too stiff becomes brittle. Brittle bones break more easily than “stiff enough” bones.
Persons with diabetes who routinely run high blood sugars fracture more easily than non-diabetics. Therefore, at the same BMD and T-score, diabetics have a higher Fracture Risk.
We knew that high blood sugars in diabetics are bad for kidneys, eyes and nerves. Now we know that high blood sugars in diabetics are bad for bones too.
Take Control of Your Future. If you have diabetes, work with your primary doc to get your blood sugars under control.
Jay Ginther, MD
Driving to Chicago in February was cold and snowing. But it was hot indoors at the ISCD (International Society for Clinical Densitometry) Annual Meeting and Position Development Conference (PDC).
While no new technologies were introduced, the PDC evaluated the scientific studies of several recent innovations. Most are best done in research centers. One recent innovation could make it to clinical centers. Trabecular Bone Score (TBS) is a software addition to DXA that adds information about the quality of bone by re-analyzing the L1, L2, L3 vertebrae.
We have discussed how adding Vertebral Fracture Assessment (VFA) to a DXA Bone Mineral Density (BMD) improves Fracture Risk calculation. TBS has the same potential. The main issues blocking TBS are software cost, added time, and the fact that all insurances (including Medicare) currently do not pay for it.
We also attended presentations about patient treatment issues. Fracture Prevention is much more than just checking a T-score with DXA. National experts shared their knowledge of medical issues that can strongly influence Bone Health and Fracture Risk. More about these sessions next time.
You can Take Control of your Future with action to decrease your fracture risk.
Jay Ginther, MD
DXA is very good at determining Bone Mineral Density (BMD), provided you look at the images and over-read the computer. DXA alone is less good at predicting Fracture Risk. But, Fractures are what we want to avoid.
At the International Society for Clinical Densitometry (ISCD) meeting this week, we will discuss the other modalities, which supplement DXA to obtain greater accuracy. Vertebral Fracture Assessment (VFA) helps evaluate bone quality. FRAX was specifically designed to predict Fracture Risk. QCT (Quantitative Computerized Tomography) has been added in recent years as an alternative to DXA.
ISCD will discuss adding TBS (Trabecular Bone Score), Hip Structural Analysis, Hip Axis Length, and uses of Central CT. We are constantly pushing toward our goal – Prevent Fractures.
Preventing Fractures is not just DXA. Get a Complete Bone Health Evaluation.
Take Control of your future. Check your bone health.
Jay Ginther, MD
“Why did I Fracture?” and “Why do I have Osteoporosis?” are common questions I hear from older women and men. They are taking Calcium and Vitamin D3, eating a diet with Protein, Fruits and Vegetables, and Exercising regularly. They are “doing everything right”, and still they have deteriorating bones. What is wrong?
The simple answer is “Birthday Disease” – too many birthdays. Increased Fracture Risk (Clinical Osteoporosis) is totally natural as we age. Women after Menopause, and men after age 70, lose 1-2% of their Bone Mineral Density (BMD), and more of their Bone Strength, every year.
When I was in Medical School, 40 years ago, that was the end of the story. Many older women (and some older men) became kyphotic (stooped over), fractured and fell, and either died or went to a nursing home for the rest of their lives. Then, there was nothing we could do to stop it. Today we can often prevent osteoporosis, fractures and misery.