Bone and Mineral Metabolism

SAT-775 - Assessment of Osteoporosis Screening and High‑Risk Medication Use in an Older Diabetes Cohort

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Location: ENDOExpo; Poster Floor

Abstract Poster Presenter(s)

Zar Chi Tun, MD

Overland Park, KS, United States

Senior Author/Primary Investigator(s)

ST

Shourya Tadisina, MD

Assistant Professor
UNIVERSITY OF MISSOURI-KANSAS CITY
Kansas City, United States
BD

Betty Drees, MD

Professor Emerita
University of Missouri at Kansas City Endocrine Fellowship Program
Kansas City, Missouri, United States

Disclosure(s):

Zar Chi Tun, MD: No financial relationships to disclose

Background:
Older adults with diabetes are at increased risk for osteoporosis, falls, fractures, and hypoglycemia‑related adverse events. However, despite these overlapping risk domains, screening practice, medication safety, and bone‑health optimization remain inconsistent in routine care.
OBEJECTIVE: To better understand gaps and opportunities, we performed a retrospective analysis of bone health care in 179 adults with type 2 diabetes mellitus (T2DM) from July 2024 to December 2024, at an urban safety net hospital.

Methods: In a retrospective chart review, 216 patients with diabetes mellitus were identified who were seen in the diabetes clinic from July- December 2024. Variables examined included age, body mass index (BMI), sex, ethnicity, payer class, dual-energy x-ray absorptiometry (DXA) order/completion, treatment for osteoporosis, 25-OH Vitamin D levels, type of diabetes, and high-risk diabetes medication. Patients not seen for T2DM were excluded. Continuous variables were summarized using means with standard deviations or medians with interquartile ranges, as appropriate. Descriptive observational statistics were calculated using Microsoft Excel (Microsoft Corporation, Redmond, WA).

Results: During the study period, 216 patients were evaluated of which 37 were excluded. A cohort of 179 patients were included in the study. Mean age was 71 (65-89) years; mean BMI was 31 kg/m2; 111 were female (62%), 68 were male (38%); 91 were African American (51%), 45 were Caucasian (25%), 43 were other races 24%), and nearly all were insured through Medicare. Osteoporosis treatment was initiated in 21 patients (12%), DXA was ordered in 74 patients (41%) and completed in 64 patients (36%). Among women ≥65, 57 of 111 (51%) had a DXA ordered, whereas only 2 of 22 men >70 ( < 5%) had a DXA ordered. The majority had 25-OH vitamin D levels measured and 36 (20%) had insufficient levels of < 30 ng/ml. Medication profiles demonstrated substantial exposure to hypoglycemia‑prone therapies: among 143( 80% ) on insulin, 46 (26%) were on both insulin and sulfonylureas, 12 (7%) were on both insulin and thiazolidinediones and 15 (8%) were on triple therapy. Screening rates were not significantly different in patients on high-risk medications.

Conclusion:
In this retrospective study, approximately 41% had documentation of bone health care through treatment or DXA screening. Bone‑health and fall‑risk management remains suboptimal in older adults with diabetes, particularly in older men with low DXA utilization. Frequent use of hypoglycemia- associated therapies underscores the need for structured bone-health pathways, fracture- risk assessment, and deprescribing strategies. Targeted, technology- enabled quality-improvement interventions may improve DXA utilization, optimize calcium and vitamin D use, and reduce fracture risk in this population.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*