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Diabetes and Bone Health By Melissa Moore Research showing an increased bone fracture risk in those with diabetes is the latest in a body of research that seeks to understand how skeletal systems interact with metabolism. In research published in 2010, lead author Thomas L. Clemens, PhD, Lewis Cass Spencer Professor of Orthopaedic Surgery and Director of Research at the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine, found the connection between bone formation and insulin production. Subjects with osteoblasts, or bone- building cells, which could not respond to insulin had lower levels of osteocalcin and osteoblasts overall — and diminished bone development as a result. Over time, this led to symptoms of diabetes, including insulin resistance and a higher weight despite no changes in diet. This was explained by the lack of osteocalcin, a hormone released during the bone for- mation process. Osteocalcin also signals the pancreas to release more insulin. "Bones make hormones that control the process of insulin release," says Clemens. "The bone is a metabolic organ — it needs to communicate with other metabolic organs in order for the organism to best utilize nutrients." Perhaps most interestingly, injections with osteocalcin caused improvement in diabetes symptoms. More research is needed to determine the exact link between metabolism and bone growth in humans, as well as the implications for developing treatments for bone disease and diabetes. With weight loss surgery, we measure our success on a different scale. The expertise of a multidisciplined team. That's how we measure success here at the Weight Loss Surgery Program at Beth Israel Deaconess Hospital – Milton. And the American College of Surgeons agrees. They've designated us a Level 2 Bariatric Center. We offer LAP-BAND and Gastric Sleeve approaches, along with focused education and support. We've even waived the program fee to help eliminate the traditional barriers to treatment. The Weight Loss Surgery team at BID – Milton. To make a referral, call 617-313-1440. 199 Reedsdale Road, Milton, MA bidmilton.org/weightloss M "People with diabetes have a higher risk of fracture than those without diabetes. In diabetics, sugar molecules are added to tissues in the body, including bone collagen. Those molecules can affect the strength of the bone collagen and how well bone cells are able to function. The process of replacing bone may also not work as well in a diabetic environment." — Mishaela R. Rubin, MD, MS, Assistant Professor of Clinical Medicine, Columbia University B O N ES A N D M E TA B O LI S M M D N E W S . CO M ■ MD NEWS Greater Boston | 1 5