Prevalence and predictors of osteopenia and osteoporosis in patients with type 2 diabetes mellitus: a cross-sectional study from a tertiary care institute in North India

Bone health in diabetes: Indian perspective

“…Relevant studies pertaining to BMD in T2D has been summarized in Table 1. In a study of 252 adults (mean age 59.9 ± 6.9 years) with >5 years of T2D, the prevalence of osteoporosis and osteopenia based on BMD T -scores was 33% and 40%, respectively [13 ▪ ]. Another cross-sectional study in 200 patients of T2D (≥50 years), the overall prevalence of osteoporosis was 35.5%.…”

“…Independent risk factors associated with an increased risk of osteoporosis in patients with T2D include female sex, old age, and normal body mass index (defined as BMI 18.5–22.9 kg/m 2 compared to BMI ≥ 25 kg/m 2 ) [13 ▪ ]. In a study, lean mass was also a predictor of bone mineral content (BMC) in patients with T2D [23].…”

“…Diabetes duration and glycemic control has been associated with lower BMD and increased risk for fractures, especially in T1D. However, studies from India do not demonstrate significant association between BMD and duration of diabetes or degree of glycemic control [13 ▪ ,15,18].…”

“…In a study, lean mass was also a predictor of bone mineral content (BMC) in patients with T2D [23]. One study showed that hypovitaminosis D (defined as 25-hydroxyvitamin D < 20 ng/ml) was independently associated with an increased risk of osteopenia (OR 7.8, 95% CI: 3.1, 19.5) and osteoporosis (OR 7.3, 95% CI: 2.8, 18.8) compared to vitamin D sufficient subjects (defined as 25-hydroxyvitamin D ≥ 30 ng/ml) [13 ▪ ]. However, two other studies failed to show any significant association between vitamin D deficiency and the prevalence of osteoporosis in patients with T2D [14,15].…”

“…Diabetes medications such as thiazolidinediones and sodium-glucose co-transporter 2 inhibitors are known to increase the risk for fractures [24]. Studies from India suggested an increased risk of osteoporosis (OR 10.6, 95% CI: 3.8, 29.3) [13 ▪ ] and a decrease in BMD at the spine and hip with the use of thiazolidinediones for 1 year [18]. In another study by Kumar et al [25], there was no significant difference in the BMD, T -scores, and Z -scores at the femoral neck and lumbar spine between T2D patients treated with thiazolidinediones for at least three consecutive years and controls.…”