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The skeletal system or musculoskeletal system as it is sometimes referred to, is your body’s support structure. At birth we have approximately 300 soft bones or cartilage. During our youth this cartilage is slowly replaced by bone with some of these bones fusing together. Thus resulting in an adult skeleton of 206 bones. These bones, along with the connective tissue gives your body its shape and form, allows for movement and protects your organs. There are 3 parts to the musculoskeletal system. Bone, which provides for the structural support and protection of organs of your body. Ligaments which are Dense connective tissue bands that connect bones to other bones, providing strength and stability to your joints. Tendons are Cord-like connective tissue that attach muscles to bones, facilitating movement. Bone is made of protein, collagen I, and minerals, especially calcium and phosphorous. Cortical bone, Is the hard-outer layer which is strong and dense. The trabecular bone, is the spongy inner layer network of trabeculae. This is lighter and less dense than cortical bone. Collagen provides a framework for the incorporation of minerals, mainly calcium phosphate into the collagen framework. Calcium phosphate makes bone hard and strong while the collagen provides flexibility so that the bone can resist breaking. Bones produce red blood cells, white blood cells, and platelets through the bone marrow (The trabecular bone), the soft, spongy tissue found inside most bones. This process is called hematopoiesis. The skeleton is also a storehouse for two minerals, calcium and phosphorus. There are 3 different bone types of Axial bones which make up the skull, hyoid, auditory ossicles, vertebral column, ribs, and sternum. The Appendicular bones make up the arms, shoulders, wrists, hands, legs, hips, ankles, and feet. Sesamoid bones are small bones found in tendons and are not included in the 206-bone count. 

bone breaks and fractures

People with diabetes are at a much higher risk of bone breaks and fractures which in turn heal poorly compared to people with out diabetes. This is due to alterations in bone metabolism and bone quality. This is true even if the patients exhibit the same bone mass. 

Joint stiffness

People with diabetes may also experience joint pain, stiffness, swelling, deformities, and a loss of movement. 

Diabetic neuropathy

Nerve damage caused by high blood sugar levels that can lead to bone and joint issues. Symptoms include sharp pain, numbness, and muscle weakness in the feet and legs. 

Extra glucose

High glucose levels can stick to joint surfaces, limiting movement and causing wear and tear. 

Collagen degradation

High glucose levels can thicken and break down collagen, which is a component of tendons and ligaments. So, eating collagen-rich foods doesn’t directly result in higher collagen levels in your body. The body needs minerals like copper, zinc, Manganese and vitamin C to help with collagen formation. The main amino acids that make collagen are proline, glycine and hydroxyproline. Hydroxyprolines structure is highly dependent on vitamin c. These amino acids group together to form protein fibrils in a triple helix structure. 

Charcot's joint

Decreased nerve function can lead to the degeneration of bones, joints, and soft tissue. Symptoms include painful, swollen joints, redness, warmth, numbness, and tingling. 

Osteoarthritis

Deteriorated cartilage between joints causes bone-on-bone friction. Symptoms include stiff or sore joints after inactivity or overuse. 

Diffuse idiopathic skeletal hyperostosis (DISH)

Also known as Forestier disease, DISH is a condition that causes the hardening of ligaments and tendons, most often in the spine. DISH is more common in people with type 2 diabetes, especially those who are obese. Symptoms include neck or upper back pain, stiffness, decreased range of motion, and tingling or numbness in the legs. 

Nutrients necessary for bone homeostasis are Calcium, Protein, Vitamin D (calciferol), Magnesium, Vitamin K1 (Phylloquinone), Phosphate and hydration.