TITLE:
Advances in Fracture Risk Assessment among Patients with Type 2 Diabetes Mellitus
AUTHORS:
Xiuling Shen, Bo Zhou
KEYWORDS:
Type 2 Diabetes Mellitus, Osteoporotic Fracture, Vertebral Fracture, Risk Assessment, Prediction Model
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.11,
November
12,
2026
ABSTRACT: Type 2 diabetes mellitus (T2DM) and osteoporosis are both common age-related metabolic diseases, and their coexistence significantly increases the fracture risk of patients. Patients with T2DM often present with normal or even increased bone mineral density, yet exhibit a higher incidence of fractures, making it difficult to accurately reflect their true bone fragility by relying solely on bone mineral density assessment. Currently available clinical assessment methods include bone mineral density measurement, Fracture-risk assessment tool (FRAX), Trabecular Bone Score, Vertebral fracture assessment (VFA), Quantitative CT, Bone Turnover Markers, and Quantitative ultrasound, but each method has varying degrees of risk underestimation or applicability limitations in the T2DM population; Although FRAX integrates multiple clinical risk factors, it does not include diabetes as an independent risk factor. Although it can be improved through correction with various parameters, there is currently no unified standard. In recent years, artificial intelligence and radiomics technology have opened new avenues for predicting T2DM fracture risk, giving rise to several machine learning models and nomogram models. However, due to limited sample sizes, insufficient external validation, and a focus mainly on overall fracture risk such as hip fractures, simple clinical prediction models targeting vertebral fractures remain scarce. This article reviews the assessment methods and research progress on fracture risk in patients with T2DM, points out the shortcomings of existing prediction models, and provides ideas for developing a new, simple, and clinically applicable T2DM vertebral fracture risk prediction model.