Objective:To investigate the clinical efficacy of insulin combined with zoledronic acid in the treatment of type 2 diabetes mellitus (T2DM) complicated by osteoporosis and its effects on bone metabolism and pancreatic β-cell function.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with T2DM complicated by osteoporosis who were treated at Wenling Hospital of Traditional Chinese Medicine from January 2021 to December 2023. The patients were divided into a control group and a study group, with 34 cases in each group. The control group received treatment with zoledronic acid combined with acarbose, while the study group received insulin combined with zoledronic acid. The clinical efficacy and improvements in bone metabolism (bone-specific alkaline phosphatase, alkaline phosphatase, osteoprotegerin), bone density, and pancreatic β-cell function (homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance) were evaluated and compared between the two groups. Additionally, the incidence of adverse reactions was also compared between the two groups.Results:The clinical overall effective rate in the study group was significantly higher than that in the control group [91.18% (31/34) vs. 67.65% (23/34), χ2 = 5.76, P < 0.05]. The levels of bone-specific alkaline phosphatase [(44.92 ± 5.92) μg/L], alkaline phosphatase [(109.12 ± 9.46) U/L], and osteoprotegerin [(331.42 ± 13.92) ng/L]in the study group were significantly higher than those in the control group [(38.25 ± 4.78) μg/L, (102.95 ± 9.23) U/L, (312.26 ± 13.11) ng/L, t = -5.11, -2.72, -5.84, all P < 0.05]. After treatment, the bone density indicators in the study group [(0.80 ± 0.12) g/cm2, (0.84 ± 0.13) g/cm2, (0.82 ± 0.10) g/cm2, (0.83 ± 0.11) g/cm2]were significantly higher than those in the control group [(0.72 ± 0.11) g/cm2, (0.73 ± 0.09) g/cm2, (0.71 ± 0.12) g/cm2, (0.74 ± 0.09) g/cm2, t = -2.87, -7.38, -4.11, -3.69, all P < 0.05]. The homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance in the study group were (54.97 ± 5.42) and (1.61 ± 0.89), respectively, which were significantly different from those in the control group [(43.11 ± 5.23), (2.46 ± 0.96), t = -25.97, 3.79, both P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 0.36, P > 0.05). Conclusions:Insulin combined with zoledronic acid can enhance clinical efficacy in patients with T2DM complicated by osteoporosis, improve bone metabolism, boost pancreatic β-cell function, and demonstrate good safety.

Objective:To investigate the clinical efficacy of insulin combined with zoledronic acid in the treatment of type 2 diabetes mellitus (T2DM) complicated by osteoporosis and its effects on bone metabolism and pancreatic β-cell function.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with T2DM complicated by osteoporosis who were treated at Wenling Hospital of Traditional Chinese Medicine from January 2021 to December 2023. The patients were divided into a control group and a study group, with 34 cases in each group. The control group received treatment with zoledronic acid combined with acarbose, while the study group received insulin combined with zoledronic acid. The clinical efficacy and improvements in bone metabolism (bone-specific alkaline phosphatase, alkaline phosphatase, osteoprotegerin), bone density, and pancreatic β-cell function (homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance) were evaluated and compared between the two groups. Additionally, the incidence of adverse reactions was also compared between the two groups.Results:The clinical overall effective rate in the study group was significantly higher than that in the control group [91.18% (31/34) vs. 67.65% (23/34), χ2 = 5.76, P < 0.05]. The levels of bone-specific alkaline phosphatase [(44.92 ± 5.92) μg/L], alkaline phosphatase [(109.12 ± 9.46) U/L], and osteoprotegerin [(331.42 ± 13.92) ng/L]in the study group were significantly higher than those in the control group [(38.25 ± 4.78) μg/L, (102.95 ± 9.23) U/L, (312.26 ± 13.11) ng/L, t = -5.11, -2.72, -5.84, all P < 0.05]. After treatment, the bone density indicators in the study group [(0.80 ± 0.12) g/cm2, (0.84 ± 0.13) g/cm2, (0.82 ± 0.10) g/cm2, (0.83 ± 0.11) g/cm2]were significantly higher than those in the control group [(0.72 ± 0.11) g/cm2, (0.73 ± 0.09) g/cm2, (0.71 ± 0.12) g/cm2, (0.74 ± 0.09) g/cm2, t = -2.87, -7.38, -4.11, -3.69, all P < 0.05]. The homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance in the study group were (54.97 ± 5.42) and (1.61 ± 0.89), respectively, which were significantly different from those in the control group [(43.11 ± 5.23), (2.46 ± 0.96), t = -25.97, 3.79, both P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 0.36, P > 0.05). Conclusions:Insulin combined with zoledronic acid can enhance clinical efficacy in patients with T2DM complicated by osteoporosis, improve bone metabolism, boost pancreatic β-cell function, and demonstrate good safety.