CALCA and type 2 diabetes mellitus: For external validation, an independent cohort of 140 patients from a different hospital (2023-2025) was used to assess model generalizability, based on the same key variables and follow-up outcomes.<h4>Results</h4>The final multivariable model identified several independent predictors of recurrent fracture in patients with OPF and T2DM, including gender, treatment, alcohol consumption, postdischarge medication duration, fall risk, calcitonin, alkaline phosphatase, and homocysteine.