Association between type 2 diabetes mellitus and bone mineral density in postmenopausal Nigerian women: a multicenter cross-sectional study

Type 2 diabetes mellitus (T2DM) and osteoporosis are intersecting non-communicable diseases disproportionately affecting postmenopausal women, particularly in low- and middle-income countries. Despite increasing global recognition of diabetes-related bone fragility, data from sub-Saharan Africa remain limited. This study examined the association between T2DM and bone mineral density (BMD) in postmenopausal women attending tertiary hospitals in Nigeria, with emphasis on prevalence, self-care practices, and associated risk factors. A hospital-based cross-sectional study was conducted across 12 tertiary hospitals in Nigeria between June 2024 and March 2025. A total of 586 postmenopausal women aged ≥ 60 years were surveyed using the Diabetes Mellitus and Bone Mineral Density Assessment Questionnaire (DMBMDAQ). BMD was assessed using DEXA scans. Descriptive statistics and chi-square tests were employed, with significance set at p ≤ 0.05. Of the participants, 71.3% had T2DM, and 62.5% had abnormal BMD. T2DM was significantly associated with low BMD (p = 0.001; OR = 0.241, 95% CI: 0.812–0.921). Only 27% adhered consistently to medications, and 41.9% achieved good glycemic control. Physical inactivity, abnormal BMI, and inadequate calcium intake were prevalent. Despite 66.4% undergoing DEXA scans, only 37.5% had normal BMD. T2DM is significantly associated with reduced BMD among Nigerian postmenopausal women. Although awareness and supplement use exist, self-care adherence remains inadequate. Integrated approaches involving screening, education, and lifestyle interventions are essential to mitigate this dual burden in aging populations.