Abstract: Objective To investigate the relationship of glycemic variability with bone mineral density (BMD) in the postmenopausal patients with type 2 diabetes mellitus(T2DM). Methods A total of 88 postmenopausal patients with T2DM were enrolled. All the patients accepted the detect of the flash glucose monitoring (FGM), and the mean blood glucose (MBG), the time in range (TIR), plasma glucose standard deviation (SD), glucose coefficient of variation (CV), and the mean amplitude of glycemic excursions (MAGE) were observed. Correlation between the biochemical indicator,glycemic variability and BMD was analyzed. Results With the decrease of BMD, the age, course of disease, glycosylated hemoglobin (HbA1c), SD, CV, MAGE were gradually increased, and body mass index (BMI), 25 (OH) D3 and TIR were decreased, with statistically significant (P<0.05). Pearson correlation analysis showed that HbA1c, SD, CV and MAGE were negatively correlated with BMD (r =-0.251, -0.317, -0.317, -0.288,all P<0.05), while BMD was positively correlated with TIR (r=0.391,P<0.001).Further, multiple linear regression analysis showed that TIR was a relevant factor of BMD (P<0.05). Conclusions Glycemic variability is related to BMD in the postmenopausal patients with T2DM, and TIR is independently and positively associated with BMD. Reducing glycemic variability may help delay the decline of bone mass.

Key words: type 2 diabetes mellitus, bone mineral density, glycemic variability, flash glucose monitoring system