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Fosamax: Can an Osteoporosis Drug Prevent Diabetes?

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Fosamax: Can an Osteoporosis Drug Prevent Diabetes?

The drug was invented to treat osteoporosis, or thinning or weakening of the bones. Now, according to a new report from researchers in Denmark, it just might prevent users from developing type 2 diabetes.

The drug is called alendronate (Fosamax) and it’s in the class of medications known as bisphosphonates. Bisphosphonates are drugs that slow or prevent bone loss by obstructing osteoclasts (cells that breaks down bones) while stimulating osteoblasts, (cells that build bones). They are also used to treat hypercalcemia, or abnormally elevated levels of calcium in the blood, as well as other conditions. They can be administered orally or by injection; the drug used in the Danish study was an oral medication.

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Scientists have known for some time that people with diabetes have a higher risk of bone fractures, which has led to conjecture that there might be a connection between blood sugar levels and bone health. Consequently, said lead author Rikke Viggers, MD, of Aalborg University Hospital in Aalborg, Denmark, “we speculated that the treatment of osteoporosis might impact the risk of type 2 diabetes.”

Using data from the National Danish Patient Registry, the researchers identified 163,588 adults who had been diagnosed with type 2 diabetes between 2008 and 2018. Slightly more than half (55%) were male and the average age was 67. The researchers then matched these individuals with nearly half a million subjects who didn’t have diabetes and used prescription records to determine which participants have ever used alendronate.

Fosamax use tied to lower type 2 risk

The researchers concluded that adults who had taken alendronate at any time in their lives had a 36% lower risk of developing type 2 diabetes compared to people who had never taken the medication. Not only that, but it also appeared that the longer a person stayed on alendronate, the lower their diabetes risk. The longest period of alendronate usage in the data was eight years, and these long-term users, it was found, had a 53% lower chance of developing type 2 diabetes. Finally, the researchers looked into the matter of drug compliance — that is, whether the patients were taking the medication regularly as directed. Drug compliance was also found to be related to a lower risk of diabetes, although the results were not as dramatic. As Dr. Viggers explained, “Though not significant, it seems that higher compliance could be related to decreased odds of type 2 diabetes.”

At this stage of research, Dr. Viggers said, it’s too early to determine why alendronate seems to have this protective effect. She did theorize, however, that inflammation and oxidative stress somehow play a role. Oxidative stress, which has been defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses, appears to have a role in the tissue damage that can accompany diabetes. Also, Dr. Viggers stated that the study had certain limitations. For one, it did not include possibly relevant data on the subjects’ physical activity levels, their body-mass index (BMI), and their use of vitamin D — all of which could have played a role in the results. It’s possible, for example, that higher rates of exercise might have done more to stave off diabetes than the use of alendronate.

Nevertheless, Dr. Viggers said, “Type 2 diabetes is a serious lifelong condition that can lead to other serious health issues such as stroke, heart disease, blindness, and limb amputation and anything that prevents, or even delays it, will also reduce a person’s risk of all these other conditions. Excitingly, our research suggests that alendronate, an inexpensive medicine widely used to treat osteoporosis, may also protect against type 2 diabetes. We believe that doctors should consider this when prescribing osteoporosis drugs to those with prediabetes or at high risk of type 2 diabetes.”

Want to learn more about type 2 diabetes? Read “Diagnostic Tests for Type 2 Diabetes” and “Welcome to Diabetes.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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