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Diabetes Drug May Mean Bone Fractures

(February 11, 2010) - A class of drugs, taken for the treatment of type 2 diabetes (Read about "Diabetes"), is being associated with increased bone fractures (Read about "Bone Fractures") in a new study. After taking a thiazolidinedione (TZD) for one year, women are 50 percent more likely to have a bone fracture than patients not taking TZDs, according to study results. And those at the greatest risk for fractures from TZD use are women older than 65.

"Older women are already at a higher risk of osteoporosis (Read about "Osteoporosis") and osteoporosis-related fractures, which might explain why they appeared to be the most affected by TZDs," says study senior author L. Keoki Williams, M.D., MPH.

TZDs such as pioglitazone and rosiglitazone help keep blood glucose levels on target by decreasing insulin resistance and making body tissues more sensitive to insulin's effects. TZDs also cut down on the amount of glucose made by the liver in patients with type 2 diabetes.

But in recent years, TZDs have been linked to bone loss and increasing fracture risk. Complicating matters, type 2 diabetes and insulin use are also associated with an increased risk for fractures.

To determine the relationship between TZD use and fracture risk in patients with type 2 diabetes, Researchers conducted a retrospective study over seven years of 19,070 patients. Among the study group, 9,620 were women and 9,450 were men.

During the study period, 4,511 patients had at least one prescription filled for a TZD. The researchers used electronically maintained medical claims data to identify non-traumatic bone fractures. The increased risk in women appeared after approximately one year of TZD use.

The location of the fractures in this group also was unique. Typically, osteoporosis-related fractures involve the vertebra and hip. This study, however, found TZD use in women to be associated with fractures of the arm and the lower leg. Similar findings were observed in treated women older than 65, who were shown to have a 70 percent increased risk for developing fractures. Men, regardless of age, were not at an increased risk for fractures.