Glucose-Lowering Drugs and Fracture Risk: a Systematic Review

TY - JOUR

T1 - Glucose-Lowering Drugs and Fracture Risk

T2 - a Systematic Review

AU - Al-Mashhadi, Zheer

AU - Viggers, Rikke

AU - Fuglsang, Rasmus

AU - de Vries, Frank

AU - van den Bergh, Joop

AU - Harsløf, Torben

AU - Langdahl, Bente Lomholt

AU - Gregersen, Søren

AU - Linde, Jakob Starup

PY - 2020/12

Y1 - 2020/12

N2 - Purpose of Review: Diabetes mellitus (DM) is associated with increased fracture risk. The aim of this systematic review was to examine the effects of different classes of glucose-lowering drugs on fracture risk in patients with type 2 DM. The heterogeneity of the included studies did not allow formal statistical analyses. Recent Findings: Sixty studies were included in the review. Metformin, dipeptidylpeptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium–glucose cotransporter 2-inhibitors do not appear to increase fracture risk. Results for insulin and sulphonylureas were more disparate, although there may be an increased fracture risk related to hypoglycemia and falls with these treatments. Glitazones were consistently associated with increased fracture risk in women, although the evidence was sparser in men. Summary: New glucose-lowering drugs are continuously being developed and better understanding of these is leading to changes in prescription patterns. Our findings warrant continued research on the effects of glucose-lowering drugs on fracture risk, elucidating the class-specific effects of these drugs.

AB - Purpose of Review: Diabetes mellitus (DM) is associated with increased fracture risk. The aim of this systematic review was to examine the effects of different classes of glucose-lowering drugs on fracture risk in patients with type 2 DM. The heterogeneity of the included studies did not allow formal statistical analyses. Recent Findings: Sixty studies were included in the review. Metformin, dipeptidylpeptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium–glucose cotransporter 2-inhibitors do not appear to increase fracture risk. Results for insulin and sulphonylureas were more disparate, although there may be an increased fracture risk related to hypoglycemia and falls with these treatments. Glitazones were consistently associated with increased fracture risk in women, although the evidence was sparser in men. Summary: New glucose-lowering drugs are continuously being developed and better understanding of these is leading to changes in prescription patterns. Our findings warrant continued research on the effects of glucose-lowering drugs on fracture risk, elucidating the class-specific effects of these drugs.

KW - fracture

KW - glucose-lowering drug

KW - diabetes

KW - antidiabetic

UR - http://www.scopus.com/inward/record.url?scp=85095703722&partnerID=8YFLogxK

U2 - 10.1007/s11914-020-00638-8

DO - 10.1007/s11914-020-00638-8

M3 - Review

C2 - 33165875

SN - 1544-1873

VL - 18

SP - 737

EP - 758

JO - Current Osteoporosis Reports

JF - Current Osteoporosis Reports

IS - 6

ER -