ObjectiveTo observe the effect of denosumab on bone metabolism indicators in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM) complicated with sarcopenia.MethodsA total of 90 middle-aged and elderly patients with T2DM complicated with sarcopenia admitted to the endocrinology department of our hospital from January 2022 to January 2024 were selected and randomly divided into the observation group and the control group by simple sorting method, with 45 cases in each group. Both groups received conventional treatment. The observation group was added with denosumab. Both groups were treated for 12 months, and relevant indicators were detected and recorded once every 3 months.ResultsBefore treatment and 3 months after treatment, there were no significant differences in indicators such as limb skeletal muscle mass index, grip strength, and walking speed between the two groups (P>0.05). After 6 months of treatment, the aforementioned indicators in the observation group were significantly increased compared with those before treatment and the control group at the same time point (P<0.01). Before treatment, there was no significant difference in the levels of osteocalcin, procollagen type Ⅰ N-terminal propeptide and β-collagen degradation products between the two groups(P>0.05). After treatment and at 6 months of treatment, the aforementioned indicators in the observation group improved better than those in the control group before treatment and at the same time point (P<0.05). There was a significant difference in the incidence of adverse reactions between the two groups (P<0.05).ConclusionDenosumab can effectively improve the muscle strength of middle-aged and elderly patients with T2DM complicated with sarcopenia, promote bone formation, reduce bone resorption, and has a positive impact on patients.