Abstract / Summary
To evaluate whether sodium-glucose cotransporter-2 (SGLT2) inhibitor use is associated with osteoporosis and dual-energy X-ray absorptiometry (DEXA)-derived bone health parameters in patients with type 2 diabetes mellitus (T2DM). This observational study was conducted at the Department of Internal Medicine, Kestel State Hospital, Bursa, Türkiye, between June 2025 and February 2026. The primary analytical cohort comprised 56 patients with T2DM undergoing clinically indicated DEXA assessment, including 31 patients not using and 25 patients using SGLT2 inhibitors. An additional group of 44 participants without diabetes was included only for secondary descriptive comparisons. The primary outcome was osteoporosis, defined as a T-score ≤ − 2.5 at the lumbar spine or femoral neck. Secondary outcomes included bone mineral density (BMD) category, worst T-score, site-specific T-scores, and BMD measurements. Logistic, linear, and ordinal regression analyses were performed. Among participants with T2DM, osteoporosis prevalence was 32.3% in those not receiving SGLT2 inhibitors and 36.0% in those receiving SGLT2 inhibitors ( p = 0.769).Among patients with T2DM, SGLT2 inhibitor exposure was not associated with osteoporosis after adjustment for age, sex, and body mass index (OR = 1.169, 95% CI: 0.328–4.170; p = 0.810). No significant associations were observed with worst T-score, lumbar or femoral neck T-scores, lumbar or femoral neck BMD, or higher BMD risk category. In this exploratory study, no statistically significant association was detected between SGLT2 inhibitor use and DEXA-derived bone health outcomes in patients with T2DM. However, the limited sample size and wide confidence intervals preclude excluding clinically meaningful associations. Larger prospective studies are required. Not applicable.