{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:29:56Z","timestamp":1784165396911,"version":"3.55.0"},"reference-count":27,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100010874","name":"Indian Society for Bone and Mineral Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010874","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014741","name":"Endocrine Society of India","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014741","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Type 2 diabetes (T2D) increases fragility fracture risk despite normal\/elevated areal bone mineral density (aBMD), attributed to compromised bone microarchitecture. However, evidence guiding pharmacologic management of diabetic bone disease remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to evaluate interim effects of zoledronate, denosumab, or teriparatide on bone microarchitecture in postmenopausal women with T2D at high fracture risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 72-week, randomized, open-label, blinded-end point (PROBE) pilot clinical trial (CTRI\/2022\/02\/039978) was conducted at a single tertiary care center in India. Participants included 129 postmenopausal women with T2D for more than 5 years and high fracture risk (prior fragility fracture and\/or T-score &amp;lt; \u22122.5 [corrected for T2D] with elevated FRAX\u00ae). Participants were randomly assigned in a 1:1:1:1 ratio to receive zoledronate 5\u2005mg annually, denosumab 60\u2005mg every 6 months, teriparatide 20\u2005\u00b5g daily, or only standard of care (calcium\/cholecalciferol) for 72 weeks. The outcome measure included a prespecified 24-week interim exploratory analysis focusing on changes in bone microarchitecture assessed by second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal tibia and radius. Bone turnover markers (BTMs) were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline demographic, biochemical, aBMD, and HR-pQCT parameters were comparable across groups. Teriparatide significantly improved total and trabecular volumetric BMD (vBMD) (at tibia and radius), trabecular number (Tb.N), trabecular bone volume fraction (BV\/TV) (at tibia), and trabecular thickness (Tb.Th) (at radius). Denosumab improved tibial trabecular vBMD and Tb.N. Zoledronate improved only tibial total vBMD. Microfinite element analysis\u2013derived strength parameters were unchanged, except for a modest increase in tibial stiffness with denosumab. BTMs decreased with antiresorptives, increased with teriparatide, and showed an anabolic window by 6 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Teriparatide demonstrated early improvements in bone microarchitecture in postmenopausal women with T2D while denosumab showed a modest increase in bone stiffness at the distal tibia. Larger, adequately powered studies are needed to clarify the relative effects of anabolic and antiresorptive therapies in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf589","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:06:56Z","timestamp":1762002416000},"page":"1408-1417","source":"Crossref","is-referenced-by-count":4,"title":["Interim Effects of Zoledronate, Denosumab, or Teriparatide on Bone Microarchitecture in Type 2 Diabetes: A Pilot Trial"],"prefix":"10.1210","volume":"111","author":[{"given":"Trupti N","family":"Prasad","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research , Chandigarh 160012 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