CalciumNEW2026-08

Glycated hemoglobin and bone mineral density in adults with and without type 2 diabetes: a cross-sectional DXA study from the Qassim region, Saudi Arabia.

Alharbi Hajed Obaid, Mohammed Amal Hussain, Alatni Sahar Mohammed, Mohamed Ahmed Layla Sharfaldeen et al. — BMC endocrine disorders

Summary

This study explored the connection between long-term blood sugar levels, measured by glycated hemoglobin (HbA1c), and bone density in adults, including those with type 2 diabetes. Researchers found that individuals with higher HbA1c, indicating less controlled blood sugar, tended to have lower bone mineral density. This suggests a potential link between managing blood sugar and maintaining strong bones.

AI-generated summary — read the original

Key points

Poor blood sugar control (high HbA1c) may be linked to lower bone density.
This association was observed in adults, including those with type 2 diabetes.
Many participants in this study had reduced bone density, such as osteopenia or osteoporosis.
The study suggests a need for further research into how blood sugar management affects bone health.

What the study looked at

What question the study asked: Researchers wanted to understand if there's a connection between long-term blood sugar control and bone density in adults, particularly those with type 2 diabetes. They aimed to see if higher blood sugar levels, indicated by glycated hemoglobin (HbA1c), might be related to weaker bones. How it was studied (design/participants): This was a cross-sectional study, meaning it looked at a group of people at a single point in time. It included 73 adults from Saudi Arabia, some with type 2 diabetes and some without. Bone mineral density was measured using a special X-ray technique called DXA, and blood tests were done to check HbA1c levels and other bone markers. What it found: The study found that a significant number of participants had lower than normal bone density. Importantly, individuals with higher HbA1c levels, indicating poorer blood sugar control, were more likely to have reduced bone density, including osteopenia and osteoporosis. However, common bone markers like serum calcium were not directly linked to bone density in this study.

Dietary takeaway

While this study didn't directly examine calcium intake, maintaining adequate calcium through foods like dairy products, leafy greens, and fortified foods is crucial for overall bone health, especially if you have conditions like diabetes that might affect your bones. Good blood sugar control, alongside a calcium-rich diet, could be important for strong bones. Remember, this is one study, and more research is needed to confirm these findings.

Abstract

BACKGROUND: This comparative cross-sectional study evaluated bone mineral density (BMD) and its association with glycemic control and biochemical bone markers among adults with and without type 2 diabetes mellitus (T2DM) in the Qassim region, Saudi Arabia. METHODS: A comparative cross-sectional study was conducted among 73 adults (comprising individuals with T2DM and non-diabetic controls) recruited from healthcare facilities in the Qassim region, Saudi Arabia. Clinical, demographic, and bone health data were collected using a structured questionnaire and hospital medical records. Glycated hemoglobin (HbA1c), serum calcium, alkaline phosphatase (ALP), fracture history, and bone mineral density were evaluated. BMD was measured at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry (DXA) and classified according to the World Health Organization (WHO) criteria. Statistical analyses were performed using SPSS version 23.0. RESULTS: T2DM was diagnosed in 69.9% of participants; 48.0% had osteopenia and 19.2% had osteoporosis. Chronological age was associated with progressive bone mineral density loss across successive cohorts (Pearson χ² = 11.14, p = 0.025). Among participants with T2DM, mean HbA1c increased progressively with longer diabetes duration (Spearman's rho = 0.310, p = 0.027). In an exploratory multinomial logistic regression model, higher HbA1c was associated with lower bone mineral density categories each 1% increase in HbA1c was associated with higher odds of osteopenia (adjusted odds ratio [aOR] = 2.34, 95% confidence interval [CI]: 1.12-4.88; p = 0.024) and osteoporosis (aOR = 3.89, 95% CI: 1.45-10.42; p = 0.007). Serum calcium and alkaline phosphatase (ALP) were not significantly associated with bone mineral density. CONCLUSIONS: Low bone mineral density was common in this study population. Higher HbA1c levels were associated with lower bone mineral density categories in an exploratory regression model adjusted for the variables included in the analysis. These findings support further investigation of the relationship between glycaemic control and bone health in larger prospective studies with comprehensive adjustment for clinical confounders.

View on PubMed →DOI: 10.1186/s12902-026-02474-w