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01-08-2015 | Review

Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review

Authors: A. Palermo, L. D’Onofrio, R. Eastell, A. V. Schwartz, P. Pozzilli, N. Napoli

Published in: Osteoporosis International | Issue 8/2015

Abstract

Fracture risk is higher in older adults with type 2 diabetes and may be influenced by treatments for diabetes. Oral anti-diabetic drugs have different effects on bone metabolism. The purpose of this review is to describe the effects of these drugs on bone metabolism and fracture risk. Osteoporosis is a progressive skeletal disorder that is characterized by compromised bone strength and increased risk of fracture. This condition has become an important global health problem, affecting approximately 200 million people worldwide. Another chronic and highly prevalent condition is diabetes mellitus, which affects more than 380 million people; both type 1 and type 2 diabetes are risk factors for fracture. Type 2 diabetes, in particular, is associated with impaired bone strength, although it is characterized by normal or elevated bone mineral density. Several therapeutic strategies are available to achieve the best outcomes in the management of diabetes mellitus but these have different effects on bone metabolism. The purpose of this narrative review is to describe the effects of oral hypoglycemic agents (metformin, sulfonylureas, thiazolidinediones, meglitinides, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-dependent glucose transporter 2 inhibitors) on bone metabolism and on the risk of developing fragility fractures in patients with type 2 diabetes. Both diabetes and osteoporosis represent a significant burden in terms of healthcare costs and quality of life. It is very important to choose therapies for diabetes that ensure good metabolic control whilst preserving skeletal health.

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Title: Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review
Authors: A. Palermo
L. D’Onofrio
R. Eastell
A. V. Schwartz
P. Pozzilli
N. Napoli
Publication date: 01-08-2015
Publisher: Springer London
Published in: Osteoporosis International / Issue 8/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-015-3123-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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