The Effect of Semaglutide on Bone Health

Inclusion Criteria: 1. Type 2 diabetes (according to WHO diagnostic criteria), 2. Age range: 50 to ≦75 years, 3. Glycosylated hemoglobin (HbA1c): 6.5 to ≦9.0%, 4. Bone mineral density (lumbar spine, hip, or femoral neck) T-score \< -1, or history of fragility fractures (hip, vertebral, distal forearm, or proximal humerus fractures) within three years before screening, 5. No use of antidiabetic medications in 8 weeks prior to enrollment (excluding metformin). Exclusion Criteria: 1. Bone mineral density (lumbar spine, hip, or femoral neck) T-score \< -2.5, 2. History of secondary osteoporosis, 3. Serious liver dysfunction or chronic kidney disease (aspartate aminotransferase (AST) or alanine transaminase (ALT) \> 2.5 times the upper limit of the normal reference, or estimated glomerular filtration rate (eGFR) \< 45 ml/min/1.73㎡), 4. History of malignant tumors, 5. Received strong anti-osteoporosis medications such as bisphosphonates, denosumab, or teriparatide within the past 2 years, 6. History of pancreatitis or triglyceride levels \>5.6 mmol/L; 7. Family history of medullary carcinoma.