Link identified between diabetes and bone formation
The skeleton…its mains functions are support, movement, and protection, right? Well, latest research from American suggests that the skeletal system may also play a part in glucose regulation, thus being a contributing factor in the development of diabetes [1]. Dr. Gerard Karsenty is leading a study at Columbia University Medical Center, which looks at the way in which osteocalcin, a hormone released by bones, can regulate the body’s glucose levels. The study in mice found that osteocalcin helps to maintain a healthy level of glucose in the blood. However, osteocalcin only works when the bone is being broken down, during the body’s usual routine. The study’s findings were lent further support from tests of a small group of patients with a genetic disorder affecting their bone regeneration.
The idea behind the study is that insulin signalling in osteoblasts is essential for whole body glucose homoeostasis as it causes an increase in osteocalcin activity. The insulin signalling in osteoblasts capitalises on the regulation of osteoclastic bone resorption that is exerted by osteoblasts. In turn, this means that changing the insulin signalling can promote or prevent the glucose metabolism in a bone resorption-dependent manner [1]. Basically, the insulin signals in osteoblasts ignite osteocalcin which in turn promotes metabolism of glucose.
This is a significant discovery because it could lead to improvements in the treatment of diabetes. It is especially relevant for the possible treatment of type 2 diabetes, as it specifically relates to glucose intolerance. It is estimated that approximately 2.5 million people in the UK have diabetes [2]. Type 2 diabetes mellitus is characterised by insulin resistance and impaired insulin secretion.
Apart from the fact that this is a discovery that could improve millions of lives, it is also a discovery that could potentially save health services millions. Diabetes treatments rack up the largest bill for the NHS, with £599.3 million worth of medication being prescribed by doctors [3]. The cost of treatment is rising alongside the newly diagnosed cases of diabetes. It is estimated that the number of people with type 2 diabetes will continue to rise in the future. In the UK, more than 100 000 people are diagnosed a year; that is the equivalent of around 250 people every day, or in a much bleaker statistic – one person every five minutes [4].
Diabetes also increases the risk of cerebrovascular accident and cardiovascular disease [4]. Effective treatment of diabetes will have a knock on benefit in the prevention and management of these conditions. 80% of people with diabetes will die from cardiovascular disease [4]. A process that began with bone regeneration can have a knock on effect until the entire cardiovascular system is involved.
Dr Karsenty’s study heralds the potential for a new era of treatment in diabetes. It opens up a field of possibilities in the development of drugs to treat or maybe even prevent the development of type 2 diabetes. The skeleton is the foundation structure that the human body is built around. It may also hold the answers to treating the conditions that can all too often ravage the body.
Suzanne Murphy
murphs34(a)tcd.ie
References
1. Ferron M, et al. Insulin signalling in Osteoblasts Integrates Bone Remodelling and Energy Metabolism. Cell; 142: 296-308
2. Whitmore C. Type 2 diabetes and obesity in adults . Br J Nursing 2010; 19: 880-86
3. Black P. Obesity and Diabetes; A Time To Act. Br J Nursing 2009; 18:1089
4. Diabetes UK. Diabetes Heartache: The hard reality of cardiovascular care for people with diabetes. Available at: http://tinyurl.com/ydrfmjv (Accessed 24th July 2010).