Valentini A, et al. - This study draws on data from a retrospective clinical study conducted at the “Tor Vergata” Polyclinic in Rome to investigate the association between the degree of metabolic compensation and the 10-year probability of a major fracture or a hip osteoporotic fracture as well as to determine whether glycosylated hemoglobin (HbA_1c) can improve the predictive value of the Fracture Risk Assessment Score (FRAX) in patients with type 2 diabetes mellitus (T2DM). Study participants were 6355 subjects over 50 years of age evaluated for osteoporosis. In subjects with T2DM, they recommend a correction factor derived from HbA_1c that could enhance the predictive ability of fracture risk estimated by the FRAX algorithm.