Denosumab Improves Glycaemic Parameters in Postmenopausal Osteoporosis Patients with Combined Type 2 Diabetes

Ke Wang1, Liu Gao2, Chang Liu3

  • 1Department of Endocrinology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei,050051, China. nimingren120@foxmail.com.

Insights

RANKL inhibitors like Denosumab may improve glucose control in postmenopausal osteoporosis patients with type 2 diabetes by increasing active GLP-1 and decreasing DPP-4. This offers potential benefits for glycaemic parameters.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Bone Metabolism

Background:

  • Postmenopausal osteoporosis and type 2 diabetes mellitus (T2DM) frequently coexist.
  • Effective management strategies are needed to address both conditions concurrently.

Purpose of the Study:

  • To investigate the effects of RANKL inhibitors on glucose metabolism in postmenopausal women with osteoporosis and T2DM.
  • To compare Denosumab with ibandronate regarding their impact on glycaemic control and related biomarkers.

Main Methods:

  • 84 postmenopausal women with osteoporosis and T2DM were randomized into Denosumab (60 mg every 6 months) or ibandronate (2 mg every 3 months) groups.
  • Blood glucose parameters, serum active GLP-1, and DPP-4 levels were assessed before and after treatment.

Main Results:

  • Denosumab group showed a significant decrease in fasting glucose compared to baseline.
  • The Denosumab group had significantly lower 2-hour postprandial glucose (2hPG) compared to the ibandronate group post-treatment.
  • Denosumab treatment increased active GLP-1 and decreased DPP-4 levels, unlike ibandronate.

Conclusions:

  • RANKL inhibitors, specifically Denosumab, may improve glycaemic parameters in postmenopausal osteoporosis patients with T2DM.
  • The beneficial effects appear mediated by increased active GLP-1 and decreased DPP-4 levels.

Related Concept Videos

Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
230
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
309
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
211
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.7K
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
205