Patients with type 2 diabetes, who are using insulin or sulfonylurea, are more likely to break bones, even if their bone mineral density is normal to high, says a new research presented today at ENDO 2022, the annual meeting of the Endocrine Society in Atlanta, Ga.

“Patients using insulin or sulfonylurea are at a high risk of fractures compared to metformin-only users, and the risk could be higher in non-obese and well-controlled diabetic patients,” noted Sung Hye Kong, M.D., of Seoul National University Bundang Hospital in Seongnam, South Korea.

Anti-diabetic drugs have long been suspected of increasing the incidence of fractures in this patient population, according to Kong and colleagues. However, they discovered that evidence of these impacts is limited after looking at longterm comparative research.

The researchers recruited 6,694 individuals from the common data model (CDM) database between the years 2008 and 2011 for their study. All of these patients were over the age of 50 and had been taking the same anti-diabetic drugs for more than a year.

They used the Cox proportional hazards model to compare the risks of major osteoporotic fractures and hip fractures in each group to a metformin group as a control.

“From real-world data using the common data model,” according to Kong, they “found that insulin users were at elevated risk of major osteoporotic and hip fracture compared to metformin users, which was attenuated in users with a combination of insulin and metformin.”

This elevated fracture risk among insulin users was exacerbated in those who were not fat and had well-controlled diabetes. These findings imply that people with diabetes should have their fracture risk assessed on a regular basis.

Image Credit: Getty

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