When assessing a person’s risk for breaking a bone, one of the things I like to look at are specific laboratory tests. Bone density exams are fairly good at showing us the QUANTITY of bone, but bone quantity does not equate to bone strength. Bone QUALITY, on the other hand, DOES correlate more to the actual strength of bone…its resistance to breaking. The problem is, we don’t have tools readily available in the clinical setting to accurately assess bone’s microarchitectural integrity (quality) first hand. We’re getting closer with technology such as the trabecular bone score (TBS) (especially when evaluating fracture risk in patients with type 2 diabetes) but we still have a long way to go. What we do have in our diagnostic arsenal today are several lab tests that correlate well to bone quality and fracture risk.

In the last Newsletter, I wrote about homocysteine, an inflammatory biomarker, that when elevated, is directly related to increased fracture risk in patients with osteoporosis. The reason for this correlation is that homocysteine compromises bone collagen molecules making them stiff and bone more prone to breaking.

Another biomarker I use to assess fracture risk is blood glucose. Like elevated homocysteine, high blood glucose also increases an osteoporotic patient’s risk to break a bone by compromising the quality of their bones.

Our skeleton is amazingly complex. It doesn’t just act as an anchor for muscles and tendons, and as a storage vessel for vital minerals, and as a birthing place for blood cells, but our bones also act as an endocrine organ involved in energy regulation, specifically that of glucose metabolism. Because of this, elevated blood glucose levels (both in pre-diabetes and diabetes) results in, 1) an increased production of advanced glycation end products (AGEs) which compromises bone collagen structure, and 2) a compromise in osteoblast and osteoclast cell function which disrupts bone remodeling equilibrium. The end result is reduced bone quantity, quality, and bone strength.


Fasting blood glucose levels should remain below 100 mg/dL. Having fasting glucose levels consistently above 100 is a red flag not just for type 2 diabetes but also for increased fracture risk if you have osteoporosis. Bringing glucose levels under control is extremely important. OsteoNaturals’ OsteoStim helps lower elevated blood glucose levels with its therapeutic amounts of alpha lipoic acid, lactoferrin, and berberine. All of these compounds (in addition to dietary considerations) are excellent for helping to lower blood glucose levels.