Abstract
Background: Postmenopausal osteoporosis is a significant public health concern, characterized by reduced bone mineral density (BMD) and an increased risk of fragility fractures. In women with type 2 diabetes mellitus (T2DM), the interplay between metabolic dysregulation, microvascular complications, and pharmacological treatments may further influence bone health. This study aims to evaluate the association between the use of antidiabetic medications and bone mineral density in postmenopausal women with type 2 diabetes mellitus. Methods & Materials: This cross-sectional study was conducted in the Medicine Department of Sir Salimullah Medical College and Mitford Hospital, from July 2023 to June 2024. A total of 120 cases were included in this study according to the selection criteria. Data were processed and analyzed by SPSS 22.0. A p-value of <0.05 was considered statistically significant. Result: Among the 120 postmenopausal women studied, those with diabetes were older, had a longer duration since menopause, and showed a significantly higher prevalence of osteoporosis (63.3% vs. 40.0%) compared to non-diabetics. In the diabetic group, the mean duration of diabetes was 10.53 ± 5.09 years, with over half having poor glycemic control (HbA1c > 7%), and treatment was almost equally divided between oral agents alone and oral agents plus insulin. However, no significant differences in bone mineral density were observed between the two treatment groups. Conclusion: This study demonstrates that postmenopausal women with diabetes mellitus have a significantly higher prevalence of osteoporosis compared to their non-diabetic counterparts, a difference likely influenced by longer duration since menopause and suboptimal glycemic control. However, no significant association was observed between bone mineral density and the type of antidiabetic treatment (oral agents alone vs. oral agents plus insulin).

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