Assessment of Bone Health in Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) affects bone health, increasing the risk of fracture despite normal or elevated bone mineral density (BMD). This paradox is attributed to impaired bone quality, microarchitectural defects and advanced glycation end-products-related damage. Additionally, complications of diabetes, such as neuropathy, retinopathy and medication side effects, contribute to increased fall and fracture risk. Traditional diagnostic tools like dual-energy X-ray absorptiometry and Fracture Risk Assessment Tool → often fail to capture these caveats, while newer techniques such as trabecular bone score and high-resolution peripheral quantitative computed tomography offer better insights but remain limited by accessibility. Refining risk assessment models, integrating novel imaging and adopting tailored management strategies are crucial to mitigating fracture risk and improving skeletal health in T2DM.