Background: Type 2 diabetes mellitus (DM) is associated with various complications, including potential effects on bone health. Although elderly patients with Type 2 diabetes mellitus may exhibit normal bone mineral density, they are paradoxically at a higher risk of fractures. The underlying mechanisms remain multifactorial and involve glycemic control, hormonal regulation, and nutrient deficiencies.
Objective: To evaluate bone mineral density (BMD) in elderly patients with type 2 diabetes mellitus and investigate its relationship with glycemic control, vitamin D levels, and calcium status.
Patients and Methods: A prospective, cross-sectional study was conducted on 46 patients aged > 65 years at Merjan Teaching Hospital Babil, Iraq, between May 2024 and May 2025. Data collected included demographics, HbA1c levels, serum vitamin D and calcium levels, and bone mineral density measured via DEXA scans at the spine and hips.
Results: Osteoporosis was present in 54.3% of the patients, and 34.8% of the patients were classified as osteopenic. The majority of the patients were females. A positive correlation was found between HbA1c and DEXA T-scores (r = 0.313, p = 0.034), and patients with poor glycemic control (mean HbA1c = 9.2%) had a higher prevalence of osteoporosis. No significant correlations were found between bone mineral density (Dexa T-scores) and serum vitamin D (r = -0.057, p = 0.705) or calcium levels (r = -0.080, p = 0.597). The right hip had the highest site-specific prevalence of osteoporosis (41.3%).
Conclusions: Osteoporosis is highly prevalent among elderly patients, particularly women. Poor glycemic control (high HbA1c level) and increased age were significantly associated with lower bone density.
Recommendation: DEXA scans of multiple sites, particularly the spine and hips, are essential for detecting osteoporosis in this population.
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Funding Statement: The study was supported by grant NN from the Foundation of Basic Research. This work was carried out under research program NNN of NN University. Author NN was supported by grant NN from the Ministry of NN.
Ethical Compliance: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Data Access Statement: Research data supporting this publication are available from the NN repository at located at www.NNN.org/download/.
Conflict of Interest declaration: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.
Author Contributions: AB and MJ contributed to the design and implementation of the research, JK to the analysis of the results and to the writing of the manuscript. VK conceived the original and supervised the project.