There is substantial, and growing, evidence that type 2 diabetes (T2D) is associated with skeletal fragility, despite often preserved bone mineral density. As post-fracture outcomes, including mortality, are worse in people with T2D, bone management should be carefully considered in this highly vulnerable group. However, current fracture risk calculators inadequately predict fracture risk in T2D, and dedicated randomised controlled trials identifying optimal management in patients with T2D are lacking, raising questions about the ideal assessment and treatment of bone health in these people. We synthesise the current literature on evaluating bone measurements in T2D and summarise the evidence for safety and efficacy of both T2D and anti-osteoporosis medications in relation to bone health in these patients.

有大量且越来越多的证据表明，2 型糖尿病 (T2D) 与骨骼脆性有关，尽管骨矿物质密度通常保持不变。由于 T2D 患者的骨折后结局（包括死亡率）更差，因此在这个高度脆弱的群体中应仔细考虑骨骼管理。然而，目前的骨折风险计算器不足以预测 T2D 的骨折风险，并且缺乏确定 T2D 患者最佳管理的专门随机对照试验，这引发了对这些人骨骼健康的理想评估和治疗的质疑。我们综合了当前关于评估 T2D 骨骼测量的文献，并总结了 T2D 和抗骨质疏松症药物与这些患者骨骼健康相关的安全性和有效性的证据。