Introduction: Diabetes mellitus is a growing global health concern, with an estimated 643 million individuals projected to be affected by 2030. Sarcopenia, once considered a normal part of aging, is now known to be associated with chronic diseases, including type 2 diabetes mellitus (T2DM). Muscle mass typically declines by approximately 8 per decade after age 40, accelerating to 15â25 per decade after age 70. Aim: To determine the prevalence of sarcopenia in patients with T2DM of more than 10 yearsâ duration and evaluate its association with bone mineral density (BMD). Methods: An observational study was conducted at a tertiary care hospital in Salem from January to October 2024. A total of 120 patients with T2DM for over 10 years were included. Data collected included demographics, medical history (fractures, comorbidities, use of insulin, bisphosphonates, or vitamin D supplements), and physical examination findings (weight, height, BMI, and blood pressure). Sarcopenia and BMD were assessed using dual-energy X-ray absorptiometry (DEXA). Results: The mean age of participants was 63.4 ± 8.7 years. Most had diabetes for 10â15 years (56.7), and 32.5 had 16â20 years. The mean BMI was 25.7 ± 3.4 kg/m<sup>2</su>. Sarcopenia was present in 30.0 of participants. Additionally, 48.3 had osteopenia and 28.3 had osteoporosis. Conclusion: Routine screening for sarcopenia and BMD in older adults with long-standing T2DM is essential for early intervention. Good glycemic control may help mitigate the risk of sarcopenia and related complications. © 2025 Elsevier B.V., All rights reserved.