Stylized image representing the communication between bone and pancreatic cells.

Bone's Surprising Role in Blood Sugar: How Osteocalcin and Insulin Talk to Each Other

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"New research uncovers the intricate dance between bone, insulin, and blood sugar, offering potential breakthroughs for diabetes treatment."

For years, bones were simply thought of as the framework that held us up, but scientists are increasingly recognizing that bones are metabolically active, influencing everything from fat deposition to blood sugar levels. Central to this idea is osteocalcin, a hormone secreted by bone cells (osteoblasts). This hormone is now understood to play a pivotal role in how our bodies handle glucose and insulin.

Think of it as a complex communication network. Insulin, produced by the pancreas, helps glucose (sugar) enter cells for energy. When this process falters, it leads to insulin resistance and high blood sugar, hallmarks of type 2 diabetes. But where do bones fit in? Research shows that osteocalcin can actually boost insulin secretion and improve how our bodies respond to it.

This article unpacks the groundbreaking research exploring this connection, diving deep into how osteocalcin and insulin interact at a molecular level. Understanding this relationship could unlock new strategies for preventing and treating diabetes.

The Bone-Insulin Connection: What Does the Science Say?

Stylized image representing the communication between bone and pancreatic cells.

Recent studies have illuminated the fascinating interplay between osteocalcin and insulin, demonstrating that bone is not just a passive structure, but an active participant in glucose metabolism. These findings build upon the recognition that osteocalcin, secreted by osteoblasts (bone-forming cells), influences both insulin secretion from pancreatic beta cells and insulin sensitivity in peripheral tissues.

One study, using MG-63 human osteoblast-like cells, investigated how glucose and insulin affect osteocalcin production and bone cell function. The researchers mimicked conditions of high blood sugar (glucotoxicity) and insulin resistance to see what would happen. The key findings were:

Insulin Boosts Osteocalcin: When insulin levels were normal and glucose was low, osteocalcin gene expression increased.
High Glucose is Bad News: When the osteoblasts experienced high glucose levels, osteocalcin production decreased, and the cells didn't differentiate properly.
Insulin Resistance Sabotages Osteocalcin: Disrupting insulin signaling in the bone cells also reduced osteocalcin production and hindered their development.
Communication Breakdown: Conditioned medium (essentially, the 'messages' the bone cells were sending) from insulin-resistant bone cells impaired insulin secretion in rat pancreatic beta cells.
Human Connection: The study also found that people with chronic high blood sugar, but not insulin resistance alone, had lower levels of circulating osteocalcin.

In essence, the study suggests a positive feedback loop: insulin encourages osteocalcin production in bone cells, and osteocalcin, in turn, supports insulin secretion from the pancreas. However, this delicate balance is disrupted by high glucose and insulin resistance, potentially contributing to a vicious cycle in diabetes.

What Does This Mean for Your Health?

While more research is needed, these findings open exciting new avenues for understanding and potentially treating diabetes. If osteocalcin plays such a critical role in insulin regulation, it could become a target for therapies aimed at improving blood sugar control. Maintaining healthy bones through proper nutrition and exercise might also have a positive impact on metabolic health. Talk to your doctor about how to optimize both your bone health and your blood sugar levels for a healthier future.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s12020-017-1396-0, Alternate LINK

Title: Insulin And Osteocalcin: Further Evidence For A Mutual Cross-Talk

Subject: Endocrinology

Journal: Endocrine

Publisher: Springer Science and Business Media LLC

Authors: Francesco L. Bilotta, Biagio Arcidiacono, Sebastiano Messineo, Marta Greco, Eusebio Chiefari, Domenico Britti, Tomoko Nakanishi, Daniela P. Foti, Antonio Brunetti

Published: 2017-09-02

Everything You Need To Know

How does osteocalcin influence blood sugar levels?

Osteocalcin, a hormone secreted by bone cells called osteoblasts, plays a pivotal role in blood sugar regulation. Research shows that osteocalcin can boost insulin secretion, improving how the body responds to insulin. This, in turn, helps glucose enter cells for energy, lowering blood sugar levels. In essence, osteocalcin acts as a key player in maintaining healthy blood sugar by supporting the actions of insulin.

What is the relationship between insulin and osteocalcin?

The relationship between insulin and osteocalcin is a positive feedback loop. Insulin, produced by the pancreas, encourages the production of osteocalcin in bone cells (osteoblasts). Osteocalcin, in turn, supports insulin secretion from the pancreas. This intricate communication network helps regulate glucose metabolism. Disruptions in this system, such as insulin resistance or high glucose levels, can negatively impact osteocalcin production and thus, blood sugar control.

How can high blood sugar affect osteocalcin production?

High blood sugar, or glucotoxicity, negatively affects osteocalcin production. Research using MG-63 human osteoblast-like cells showed that when bone cells experienced high glucose levels, osteocalcin production decreased. This reduction in osteocalcin can disrupt the positive feedback loop with insulin, potentially contributing to a worsening of blood sugar control. Furthermore, the study found that people with chronic high blood sugar also had lower levels of circulating osteocalcin.

What is the role of osteoblasts in the context of blood sugar and insulin?

Osteoblasts, the bone-forming cells, are central to the osteocalcin-insulin connection. Osteoblasts secrete osteocalcin, which influences both insulin secretion and insulin sensitivity. The study revealed that when insulin levels were normal, and glucose was low, osteocalcin gene expression in osteoblasts increased. However, under conditions of high glucose or insulin resistance, osteocalcin production by osteoblasts decreased, highlighting the crucial role these cells play in the delicate balance of blood sugar and insulin regulation. The conditioned medium from insulin-resistant bone cells (that is, the messages they send) impaired insulin secretion in rat pancreatic beta cells.

Could therapies targeting osteocalcin improve diabetes treatment?

Yes, the critical role of osteocalcin in insulin regulation opens exciting possibilities for diabetes treatment. If osteocalcin levels are a key factor in managing blood sugar, it could become a target for therapies aimed at improving blood sugar control. For example, interventions that boost osteocalcin production or enhance its effects could help improve insulin sensitivity and glucose metabolism. Further research is needed, but these findings suggest that maintaining healthy bones through proper nutrition and exercise might have a positive impact on metabolic health and present new avenues for preventing and treating diabetes.