Background: Diabetes mellitus (DM), whose prevalence has increased by fourfold over the preceding three decades, is the ninth greatest cause of mortality worldwide. Along with cardiovascular illnesses, osteoporosis has been listed as one of the side effects of DM. Osteoporosis is a common skeletal illness characterized by decreased bone density, which increases the risk of fracture for those who have it. DM is linked to a higher risk of bone thinning, which raises the likelihood of osteoporotic fractures and consequently lowers quality of life. However, the precise relationship between the risk of falling and diabetic complications is unclear. Studies have shown that cardiovascular and cerebrovascular effects of T2DM may be a possible cause for this connection. It is crucial to recognize osteoporosis in individuals with T2DM as an early indicator of disease status aggravation or inadequate management of CVD and cerebrovascular disorders. Material and Methods: The present study is a retrospective cross-sectional study conducted on T2DM patients with documented atherosclerosis as clinical evidence of both cardiovascular complications (Group A). The study subjects were selected based on the inclusion criteria and aged matched with T2DM patients without cardiovascular or cerebrovascular complications (Group B) after socio-demographical data was obtained from via questionnaire administration. The selected participants were subjected to venous blood samples collection for measurement of serum bone markers (osteocalcin, CT, serum phosphorus, serum calcium and vitamin D3) as well as serum cardiovascular parameters (D-dimer, HbA1c, cholesterol, triglycerides, and HDL. Results: A total of 124 patients with T2DM were recruited in the study. Group A comprised of a total of 64 patients (34 males, 30 females) with a mean age of 49.27±3.39 years and average disease duration of 6.28±5.13 years. Group B comprised of a total of 60 patients (36 males, 24 females), with a mean age of 47.73±4.49 years and mean disease duration of 6.43±5.50 years. In Group A, hospital admission was 46.9% with 50 patients having chest pain, 22 patients had brain stroke, and 42 patients have some form of heart complications with 38 patients (i.e. 59.4%) having joint pain. In Group B, hospital admission was 0 as none of them were found to have cases of chest pain, brain stroke, or any form of heart complications but 32 patients had joint pain. Serum D-dimer and cholesterol levels were significantly higher in Group A compared to Group B (p < 0.05). Significantly lower HDL levels were observed in Group A patients compared to Group B. The mean serum calcium level ad serum PO4 levels of Group A were significantly lower than in Group B respectively (p < 0.05). Conversely, serum CTx and osteocalcin levels were significantly higher in Group A compared to Group B, with mean values of CTx (6.45±1.90 ng/mL Group A vs. 5.22±1.32 ng/mL Group B) and osteocalcin (55.85±31.82 ng/mL Group A vs. 44.83±25.68 ng/mL Group B) (p < 0.05). Conclusion: i. The clinical conditions of T2DM patients who have atherosclerosis and related cardiovascular problems worsen. ii. Atherosclerosis causes dyslipidemia and thrombosis risk in T2DM patients, both of which worsen their cardiovascular disease and high risk of brain stroke. iii. Patients with T2DM who have atherosclerosis have a higher risk of developing osteoporosis than those who do not. iv. The risk of osteoporosis in T2DM patients is further exacerbated by the co-existence of cardiovascular and cerebrovascular illnesses
