In the last decades, the global rise of obesity and sedentary lifestyles, together with an aging population, lead to increased incidence and prevalence of type 2 diabetes (T2DM). T2DM is a major cause of disability, socioeconomic costs, and increased risk of all-cause mortality, although screening programmes and the availability of effective therapies prevent or delay complications.

Fragility fractures are increasingly recognized as an important complication of T2DM and are associated with excess morbidity, mortality, and health care costs. Bone mineral density (BMD) in T2DM is often normal or even slightly elevated compared with an age-matched control population. Thus, the standard diagnostic tool for osteoporosis based on DXA derived BMD seems not enough for the identification of T2DM patients at risk for fracture. Osteoporosis is often an underdiagnosed T2DM related complication. Moreover, the complex pathophysiology that contributes to bone damage in T2DM remains still largely unknown.

This Special Ossue aims to update the clinical approach to fracture risk in subjects with T2DM and to move the field forward, suggesting how to decrease the fracture rate in the clinical scenario. We welcome both original research and review articles.

Potential topics include but are not limited to the following:

• Update on the epidemiology of fractures in T2DM
• Clinical and instrumental diagnostic tools of bone fragility in T2DM
• Pathogenesis of bone fragility in T2DM
• Biomarkers predictive of bone fragility in T2DM
• Prevention of fractures in T2DM
• The role of antidiabetic drugs on bone health and fracture rate
• The effects of antiosteoporotic drugs on T2DM patients