Relationship Between Bone Mass Density and Nutritional Status of Women Diagnosed with Type 2 Diabetes Mellitus in Charsadda

The prevalence of low bone density among women is common but remains under-documented. Objectives: To assess bone mass density (BMD) levels and their relationship with nutritional status in type 2 diabetes mellitus (T2DM) women visiting the NEAT Clinic in Charsadda, Khyber Pakhtunkhwa (KPK). Methods: Using an observational, cross-sectional design, data were collected from 408 women through a structured self-reported questionnaire covering osteoporosis risk factors, sociodemographic information, anthropometrics, general health, BMD, and dietary intake. BMD was measured via Quantitative Ultrasound Scan (QUS) at the calcaneus using the Sahara clinical bone sonometer. Initially, 605 women expressed interest, but data were collected for 450 participants due to drop-out and incomplete questionnaires. Results: The mean T-score was –1.76 ± 0.81 (median: –1.72), ranging from –3.5 to 1.4. Women classified as normal, osteopenic, and osteoporotic had mean T-scores of –0.42 ± 0.43, –1.66 ± 0.34, and –2.66 ± 0.25, respectively. The prevalence of osteopenia was 59.8% and that of osteoporosis was 22.2%, while only 18% had normal BMD. QUS scores showed significant correlations (p<0.05) with age, menopausal duration, BMI, waist-hip ratio (WHR), and education level. Nutritional factors such as energy, protein, calcium, and phosphorus intake were also positively associated with QUS scores. Conclusions: The study reveals a high prevalence of osteopenia and osteoporosis among women in this population, with bone health strongly linked to both demographic and dietary factors.