Bone health isn’t often the first concern that comes to mind when discussing diabetes and obesity. Yet, new research out of Texas A&M University is uncovering a hidden link between these conditions and the body’s ability to heal from bone fractures. With obesity and Type 2 diabetes affecting over 100 million Americans, the implications of this research could be far-reaching. One natural keyword phrase that emerges from this story is “bone fracture healing in diabetes,” a topic now gaining overdue attention in the medical community.

Dr. Srividhya Iyer, an assistant professor in the Texas A&M College of Veterinary Medicine and Biomedical Sciences, is leading a team that aims to understand why fractures heal poorly in people with obesity and diabetes. Supported by a $1.6 million grant from the National Institutes of Health, her research is focused on identifying the biological mechanisms that interfere with normal bone repair in these populations. I found this detail striking: despite advances in diabetes management, the risk of fracture-related complications remains disproportionately high for these individuals.

According to Iyer, people with Type 2 diabetes and obesity are more likely not only to experience fractures but also to suffer from prolonged or incomplete healing. This can lead to a cascade of complications, including the need for surgery and, in some cases, amputation. The American Diabetes Association reports that over 160,000 diabetics in the U.S. undergo amputations annually. These are not just numbers—they reflect real, life-altering outcomes for patients and their families.

Until recently, bone health was not a major focus in discussions about diabetes and obesity. The emphasis remained on cardiovascular risks, nerve damage, and blood sugar regulation. However, as Iyer explains, “What has not been appreciated is that they also have weaker bones, which increases the chance of fracture.” This realization is shifting the conversation, highlighting the need for comprehensive care that includes skeletal health.

Another natural keyword phrase that fits seamlessly here is “bone repair in obese patients.” The healing process, typically straightforward in healthy individuals, becomes significantly more complicated in those with metabolic disorders. A fracture that might require four weeks in a cast for one person could take much longer for someone with diabetes or obesity. This extended healing time can translate into longer periods of disability, increased healthcare costs, and diminished quality of life.

Standard diagnostic tools like X-rays and bone mineral density tests often fail to detect the subtle differences in bone quality among these patients. As a result, the issue has remained under the radar until now. “When a broken bone does not heal properly, there is pain and swelling in addition to what a patient may normally experience from a fracture,” Iyer noted. Often, the next step is surgery. If that fails, amputation may be the only remaining option. These outcomes underscore the urgency of Iyer’s research.

The team is diving into what Iyer describes as a “black box”—the unknowns in how bone healing is disrupted in people with diabetes and obesity. Normally, injury triggers a cascade of cellular responses that form a bridge across the fracture site, eventually restoring the bone. In affected individuals, this process may stall or fail entirely. Whether the cells are not producing enough healing material or whether that material is being broken down prematurely remains unclear. Answering these questions is central to the research effort.

One of the more sobering aspects of this issue is its persistence even after other symptoms are managed. “Even when blood sugar is stable with medication, a person can have low rates of bone healing,” Iyer explained. The likelihood of needing additional surgeries increases, along with the risk of infections and even mortality. What was once considered a complication of aging is now affecting people across all age groups, a trend that has significant implications for public health in Texas, across the United States, and globally.

There is, however, reason for hope. Iyer’s team is also exploring pharmaceutical interventions that could help bones in diabetic or obese individuals heal more like those in lean individuals. This brings us to another important keyword phrase: “therapeutic drugs for bone healing.” By testing medications that might override the body’s impaired healing response, the researchers are aiming to “trick” the body into initiating and completing the repair process.

“We know that obesity and Type 2 diabetes are associated with certain changes in the body, like higher blood glucose, insulin resistance and the altered sentinel functions of the cell,” Iyer said. These changes may be suppressing the body’s natural healing mechanisms. If a drug can reset or bypass these barriers, it could represent a major breakthrough in how fractures are treated in these populations.

As obesity rates continue to climb—Texas currently ranks tenth among U.S. states in prevalence—the need for innovative, effective treatments becomes ever more pressing. By focusing on the intersection of metabolic disorders and skeletal health, Iyer’s work is opening new avenues for care and prevention. Bone health in diabetes and obesity is no longer a side note; it’s becoming a central concern in the broader effort to improve outcomes and quality of life for millions of people.

Read more at stories.tamu.edu