Conventional antidiabetic agents and bone health: A pilot case-control study
Jeffrey Pradeep Raj1, Shreeraam Venkatachalam2, Mahesh Shekoba2
1Department of Pharmacology, St. John's Medical College, Bengaluru, Karnataka, India.
Perspectives in Clinical Research
|October 26, 2019
Summary
Certain antidiabetic agents like sulfonylureas and insulin appear protective against osteoporosis in type 2 diabetes mellitus (T2DM) patients. However, increased fracture risk from hypoglycemia warrants caution.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Bone Health
Background:
- Noncommunicable diseases, including type 2 diabetes mellitus (T2DM) and osteoporosis, are increasing with global longevity.
- Uncontrolled T2DM is a known risk factor for osteoporosis, potentially mediated by the insulin-osteocalcin pathway.
Purpose of the Study:
- To investigate the association between commonly used antidiabetic agents (ADAs) and osteoporosis risk in T2DM patients.
- To analyze the impact of different ADAs on bone health outcomes.
Main Methods:
- A case-control study involving 100 osteoporosis cases and 100 matched controls.
- Data collection included T2DM status, ADA prescriptions, physical activity, and disease status via questionnaire.
- Statistical analysis used Chi-squared tests and binary logistic regression, adjusting for glycemic control and physical activity.
Main Results:
- Sulfonylureas (aOR=0.164) and insulin (aOR=0.248) demonstrated a significant protective effect on bone health.
- Biguanides and thiazolidinediones showed increased osteoporosis risk in univariate analysis, which became insignificant after multivariate adjustment.
Conclusions:
- Sulfonylureas and insulin may exert a favorable effect on bone health in T2DM patients, possibly via the insulin-osteocalcin pathway.
- Caution is advised regarding the potential for increased fractures due to hypoglycemic falls associated with these agents.
- Larger prospective studies are recommended to validate these findings.
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