People with type 2 diabetes often have denser bones yet remain at higher risk of fractures, and new research suggests that bone loss does not account for this paradox. The findings were published in Diabetes Care.
Researchers from the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife used novel bone imaging technology to examine two bone compartments in older adults: the hard outer layer (cortical bone) and the spongy inner layer (trabecular bone). The study aimed to understand why individuals with type 2 diabetes face greater fracture risk despite often having higher bone density.
Contrary to expectations, the team found that bone loss was similar in older adults with and without type 2 diabetes. Lead author Dr Alyssa Dufour, Associate Scientist at the Marcus Institute and Instructor in Medicine at Harvard Medical School, explained that researchers had expected to observe greater changes in bone microstructure and strength in people with type 2 diabetes.
Senior author Dr Elizabeth Samelson, Principal Investigator of the NIH-funded project, noted that although people with type 2 diabetes often have denser bones, they are still more likely to suffer fractures. This paradox suggests that bone density alone does not tell the whole story and highlights the importance of understanding other factors that influence bone strength and fracture risk.
The findings indicate that standard bone density measurements may not adequately capture fracture risk in people with type 2 diabetes, suggesting the need for additional assessments or biomarkers to identify those at highest risk. Further research is needed to identify other factors, beyond bone loss, that contribute to increased fracture susceptibility in this population.
Source: News Medical / Hebrew SeniorLife Marcus Institute for Aging Research (Diabetes Care, 2026)
