Denosumab's Role in Reducing Type 2 Diabetes Risk and Improving Glycaemic Control in Osteoporotic Patients - A
R Ngo1, D De-Jesus1, C Azucena1
1Department of Orthopaedics, Jose R Reyes Memorial Medical Center, Manila, Philippines.
Malaysian Orthopaedic Journal
|May 4, 2026
Summary
Denosumab treatment significantly reduced type 2 diabetes (T2D) incidence by 22% in postmenopausal women and the elderly. While it also showed potential benefits in fasting blood sugar (FBS), further research is needed for HbA1c and HOMA-IR effects.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Bone Metabolism
Background:
- Osteoporosis is prevalent in postmenopausal women and the elderly, increasing fracture risk.
- Emerging research links bone metabolism and glucose regulation, suggesting implications for type 2 diabetes (T2D) risk.
- Denosumab, an osteoporosis treatment, may potentially lower T2D risk.
Purpose of the Study:
- To evaluate the impact of denosumab on T2D incidence.
- To assess denosumab's effects on glycaemic markers: fasting blood sugar (FBS), HbA1c, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).
Main Methods:
- A meta-analysis of randomized controlled trials and cohort studies comparing denosumab to placebo or other osteoporosis treatments.
- Searches conducted in PubMed, Cochrane Library, and Embase.
- Study quality assessed using the Cochrane risk-of-bias tool; primary outcome was T2D incidence.
Main Results:
- Denosumab demonstrated a 22% reduction in T2D incidence (HR = 0.78, p<0.00001).
- Small, non-significant reductions observed in FBS, HbA1c, and HOMA-IR across included studies.
- Absolute risk reduction for T2D was minimal (ARR = -0.01).
Conclusions:
- Denosumab may offer metabolic benefits, including a reduced risk of T2D and improved FBS.
- The observed effects align with denosumab's role in bone turnover and RANKL inhibition.
- Further investigation is warranted to clarify denosumab's impact on HbA1c and HOMA-IR.
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