[Antidiabetic drugs and their effect on bone]

It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus are at an increased risk of bone fractures. Today we have several groups of effective and save antidiabetic drugs, which are very given often in combination. Although diabetes-related complications are important in the etiology, the effects of medications on bone metabolism and fracture risk should not be neglected, because the diabetes medication may affect also bone health and fracture risk. Increased risk of fracture has been identified with use of thiazolidinediones, most definitively in women. Also treatment with sulfonylureas can have negative adverse effect on bone. One consequence of these findings has been greater attention to fracture outcomes in trails of new diabetes medication (incretins and SGLT2 inhibitors). The aim of the review is to summarize effects of antidiabetic treatment on bone - bone mineral density, fractures and bone turnover markers. The authors also try to recommend a strategy how to treat a diabetic patient regarding the risk of osteoporotic fractures.Key words: antidiabetic drugs - diabetes mellitus - fracture risk - osteoporosis.