Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 2 2023 01 30 334 339 Sain Sattar Safarova Department of Internal Medicine, Azerbaijan Medical University, Baku, Azerbaijan 2022 03 26 2022 06 29 Background: This study aimed to determine the directionality of changes in serum bone remodeling markers and bone mineral density in the pre- and postmenopausal women with diabetes mellitus. Methods: This study was carried out during the years 2016–2017 on the basis of Azerbaijan Medical University and included 142 pre- and postmenopausal women with type 1 and 2 diabetes mellitus (DM 1and DM2) were compared with 43 age-matched non-diabetics. The groups evaluated Ca2+, PTH, CT, 25(OH)D levels, serum bone remodeling markers (ALP, P1NP, b-CTx), lumbar spine, proximal and femoral neck areas using DXA assessment. Results: The results showed inconsistency observed between bone remodeling processes in women with diabetes. A negative correlation was observed between duration of diabetes and Lumbar T-scores (DM1: r = -0.568, P = 0.001; DM2: r = -0.267, P = 0.04). Lumbar T-scores was negatively correlated with b-CTx level (DM1: r = -0.452, P = 0.002; DM2: r = -0.357, P = 0.09). Postmenopausal groups with DM1 and DM2 were slightly higher b-CTx levels than premenopausal. Conclusion: The patients with DM2 compared to DM1 had higher average BMD at all measured areas. Bone fragility is the result not so much of a decrease in BMD, but alterations in bone microstructure, as indicated by the disregulation of bone remodeling markers. This suggests that patients with diabetes are at a higher risk of bone turnover disorders compared to individuals without diabetes, which does not necessarily correlate with differences in BMD. https://ijph.tums.ac.ir/index.php/ijph/article/view/28254 https://ijph.tums.ac.ir/index.php/ijph/article/download/28254/7858