The Effect of Semaglutide on Bone Health

Inclusion criteria

• Type 2 diabetes (according to WHO diagnostic criteria),
• Age range: 50 to ≦75 years,
• Glycosylated hemoglobin (HbA1c): 6.5 to ≦9.0%,
• Bone mineral density (lumbar spine, hip, or femoral neck) T-score < -1, or history of fragility fractures (hip, vertebral, distal forearm, or proximal humerus fractures) within three years before screening,
• No use of antidiabetic medications in 8 weeks prior to enrollment (excluding metformin).

Exclusion criteria

• Bone mineral density (lumbar spine, hip, or femoral neck) T-score < -2.5,
• History of secondary osteoporosis,
• Serious liver dysfunction or chronic kidney disease (aspartate aminotransferase (AST) or alanine transaminase (ALT) > 2.5 times the upper limit of the normal reference, or estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73㎡),
• History of malignant tumors,
• Received strong anti-osteoporosis medications such as bisphosphonates, denosumab, or teriparatide within the past 2 years,
• History of pancreatitis or triglyceride levels >5.6 mmol/L;
• Family history of medullary carcinoma.