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Ongoing mechanistic and clinical research will determine whether these agents possess inherent reproductive benefits or primarily facilitate fertility through systemic metabolic restoration

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The conflicting data in some clinical studies may be explained by various factors: [1] most cohort studies lacked individual validation of fractures as primary outcomes, [2] the studies had short follow-up duration and [3] did not consider important risk factors for osteoporosis such as BMD (even though BMD is not a good method for diagnosing osteoporosis in T2DM), and [4] some studies included medications that affect fracture risk, such as corticosteroids or antidepressants