Is BMD enough for assessment of osteoporosis in post-menopausal women with diabetes ? The role of TBS

Summary of the Article

1. Title of the article
Trabecular Bone Score in Asian-Indian Post-menopausal Women Across the Spectrum of Hyperglycaemia: Insights from a Cross-Sectional Study

2. First two Authors followed by et al.
Tanushi Aggarwal, Ravi Shah et al.

3. One line summary of the article
TBS is significantly lower in post-menopausal women with T2DM compared to non-diabetics, despite similar aBMD, indicating its utility in assessing fracture risk.

4. Six key points from the article

1. aBMD did not differ significantly among T2DM, pre-diabetes, and normoglycaemic groups, but TBS was significantly lower in T2DM women.
2. TBS negatively correlated with HbA1c (r = −0.315) and duration of diabetes (r = −0.197), indicating worse bone microarchitecture with poor glycemic control and longer disease duration.
3. TBS-adjusted FRAX scores predicted higher fracture risk compared to unadjusted FRAX in T2DM patients.
4. Adjusting FRAX with TBS led to a 33% increase in the number of individuals qualifying for osteoporosis treatment per ISBMR guidelines.
5. No significant difference in TBS was seen between pre-diabetic and normoglycaemic groups.
6. TBS may offer superior risk stratification over aBMD in post-menopausal women with T2DM for fragility fractures.

5. Practical take home message
In post-menopausal women with type 2 diabetes, TBS should be considered alongside aBMD to more accurately evaluate bone quality and fracture risk, especially when conventional measures appear normal.

6. Citation for the article in Vancouver format
Aggarwal T, Shah R, Pal R, Rastogi A, Singla V, Bhadada SK. Trabecular bone score in Asian-Indian post-menopausal women across the spectrum of hyperglycaemia: Insights from a cross-sectional study. Indian J Endocr Metab. 2025;29(1):43–8. doi:10.4103/ijem.ijem_310_24