Diabetes and Osteoporosis

It’s not uncommon for people with Type 2 diabetes (T2D) to also develop osteoporosis (a condition that causes weak or brittle bones). Part of the reason is just getting older, but some diabetes medications affect bone metabolism and so does the disease itself. Researchers have found that the risk of bone fractures is rising in people with diabetes.

Recently a group of researchers in Greece and London published the results of a comprehensive review of human studies and guidelines in order to come up with recommendations on the best way to treat diabetes and osteoporosis together. They developed a grading system to evaluate the various recommendations, grading them for both strength and for the quality of the evidence.

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They concluded that four medications, used together, bring the best results. The medications are metformin, sulfonylureas, DPP-4 inhibitors, and GLP1 receptor agonists. As Stavroula A. Paschou, MD, the lead author of the report, put it, these “should be the preferred treatment for T2D in patients who also have osteoporosis.” All four medications protect the bones. Metformin has been shown to have favorable effects on bone formation and density, while DPP-4 inhibitors and GLP1 receptor agonists, according to the new report, have either beneficial or neutral effects. The researchers didn’t discover any evidence indicating that common osteoporosis medications affect glucose metabolism. They also added that for patients with diabetes who are hospitalized for fractures, insulin is the preferred therapy.

Want to learn more about diabetes and osteoporosis? Read “Diabetes and Bone Health,” “Boning Up On Bone Health,” and “Osteporosis: Yet Another Complication of Diabetes? Part 1,” Part 2, and Part 3.