Publication Name	World Journal of Diabetes
Manuscript ID	116349
Country	China

Category	Medicine, Research & Experimental
Manuscript Type	Systematic Reviews
Article Title	Umbrella review protocol type 2 diabetes mellitus and fracture risk
Manuscript Source	Unsolicited Manuscript
All Author List	Wen-Hui Zou, Zi-Yu Zhou, Ying-Qi Feng, Ru-Tong Wang, Jia-Jun Jiang, Run-Ze Zhang and Jian-Wei Li
Funding Agency and Grant Number	Funding Agency Grant Number Undergraduate Innovation Training Program of Hunan Provincial Department of Education 202510555087
Corresponding Author	Jian-Wei Li, Academic Fellow, Associate Chief Physician, Clinical Assistant Professor (Honorary), Department of General Practice, Central Hospital of Xiangtan (The Affiliated Hospital of Hunan University), No. 120 Heping Road, Yuhu District, Xiangtan 411100, Hunan Province, China. xyljw119@126.com
Key Words	Type 2 diabetes mellitus; Fracture risk; Umbrella meta-analysis; Bone fragility; Heterogeneity
Core Tip	This umbrella review reveals the complex, site-specific relationship between type 2 diabetes mellitus (T2DM) and fracture risk. Contrary to the elevated risk for overall, non-vertebral, and ankle fractures, T2DM was associated with a significantly reduced risk of hip fracture. This paradoxical finding challenges conventional views and may be attributed to skeletal compensatory adaptations in T2DM, such as adaptive increases in bone density. The study underscores the necessity of moving beyond a generalized fracture risk assessment and developing individualized, site-specific prevention and management strategies for patients with T2DM.
Citation	Zou WH, Zhou ZY, Feng YQ, Wang RT, Jiang JJ, Zhang RZ, Li JW. Umbrella review protocol type 2 diabetes mellitus and fracture risk. World J Diabetes 2026; In press

Received	2025-11-13 08:12
Peer-Review Started	2025-11-13 08:47
First Decision by Editorial Office Director	2025-12-30 07:43
Return for Revision	2025-12-30 07:43
Revised	2026-01-13 12:38
Publication Fee Transferred	2026-01-14 13:07
Second Decision by Editor	2026-03-10 02:51
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-10 10:16
Articles in Press	2026-03-10 10:16
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Typeset the Manuscript

ISSN	1948-9358 (online)
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