Bone May Have a Role in Blood Sugar ControlThe human skeleton plays an important role in regulating blood sugar, says a new study. ![]() Researchers report their findings in the science journal Cell, and say their work has helped define how bone controls this process. Led by Gerard Karsenty, MD, Ph.D., at Columbia University Medical Center, the team found that the destruction of old bone during normal skeletal regrowth - a process known as resorption - is needed to maintain a healthy level of glucose in the blood. While resorption is a process that occurs throughout life to make way for new bone, Dr. Karsenty's team found that it also acts to stimulate the release of insulin into the bloodstream and improve the uptake of glucose by cells in the entire body. The findings suggest that, for some people, diabetes may develop from changes in the skeleton, and that drugs designed to stimulate the bone-insulin pathway may lead to better drugs for type 2 diabetes. Insulin Is a "Street-Smart Molecule"In 2007, Dr. Karsenty discovered that a hormone released by bone - known as osteocalcin - can regulate glucose levels. This was a first clue that the skeleton may have an important role in regulating blood glucose. Osteocalcin turns on the production of insulin in the pancreas and improves the ability of other cells to take in glucose. Both of these processes are impaired in type 2 diabetes. The researchers found that osteocalcin cannot work until cells that degrade bone start working and begin the resorption process. As the cells degrade bone, inactive osteocalcin is converted to its active form by the increase in acidity around the bone. Dr. Karsenty says insulin was discovered to favor bone resorption and it favors the activation of osteocalcin, which in turn favors insulin synthesis and secretion. He calls insulin is a "street-smart molecule" that takes advantage of the functional interplay between bone resorption and osteocalcin. Human Skeleton Sheds Important Light on DiabetesBy identifying the tight connection existing between energy metabolism and skeleton physiology, the study further underscores the function exerted by the skeleton. The finding further strengthens the idea that diabetes could be treated by increasing the level of osteocalcin in the body. In addition, the researchers suggest that since most drugs to treat another condition - osteoporosis - work by inhibiting bone resorption, the drugs may decrease the activation of osteocalcin and cause glucose intolerance in some patients. "This research has important implications for both diabetes and osteoporosis patients," says Dr. Karsenty. "First, this research shows that osteocalcin is involved in diabetes onset, and secondly, bone may become a new target in the treatment of type 2 diabetes as it appears to contribute strongly to glucose intolerance. "And for people with osteoporosis, the concern is that a common treatment - bisphosphonates - which work by inhibiting bone resorption and therefore may increase glucose intolerance, could push someone with borderline glucose intolerance into full-fledged disease onset. Although, more research is needed to study this further," said Dr. Karsenty. Always consult your physician or other healthcare provider for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) CDC - Diabetes Public Health Resource Cell - Insulin Signaling in Osteoblasts Integrates Bone Remodeling and Energy Metabolism National Diabetes Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
September 2010More About DiabetesDiabetes is a metabolic disorder characterized by a failure to secrete enough insulin, or, in some cases, the cells do not respond appropriately to the insulin that is produced. Because insulin is needed by the body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood. Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, malnutrition, infections, viruses, or other illnesses. The three main types of diabetes - type 1, type 2, and gestational - are all defined as metabolic disorders that affect the way the body metabolizes, or uses, digested food to make glucose, the main source of fuel for the body. For glucose to be able to move into the cells of the body, the hormone insulin must be present. Insulin is produced primarily in the pancreas, and, normally, is readily available to move glucose into the cells. However, in persons with diabetes, either the pancreas produces too little or no insulin, or the cells do not respond to the insulin that is produced. This causes a build-up of glucose in the blood, which passes into the urine where it is eventually eliminated, leaving the body without its main source of fuel. Diabetes affects an estimated 23.6 million people in the US (90 percent to 95 percent have type 2 diabetes) - 17.9 million have been diagnosed, but 5.7 million are unaware they have the disease. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the American Diabetes Association, those affected include:
According to the most recent statistics, diabetes was the sixth leading cause of death, and the fifth leading cause of death from disease in 2007. Diabetes costs $116 billion annually in direct medical costs. Diabetes costs $58 billion annually in indirect costs (loss of work, disability, loss of life). Always consult your physician or other healthcare provider for more information. |