Glucose-Lowering Drugs and Fracture Risk: a Systematic Review

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

  • Zheer Al-Mashhadi
  • Rikke Viggers, Aalborg University
  • ,
  • Rasmus Fuglsang
  • Frank de Vries, Department of clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Netherlands
  • Joop van den Bergh, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands., Department of Internal Medicine, VieCuri Medical Centre, Venlo
  • ,
  • Torben Harsløf
  • Bente Lomholt Langdahl
  • Søren Gregersen
  • Jakob Starup Linde

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.

Original languageEnglish
JournalCurrent Osteoporosis Reports
Pages (from-to)737-758
Number of pages22
Publication statusPublished - Dec 2020

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