The effect of antidiabetic treatment on the bone of patients with type 2 diabetes

Czech version

Authors: David Karásek
Authors‘ workplace: III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP a FN Olomouc
Published in: Vnitř Lék 2016; 62(7-8): 582-587
Category: Reviews

Overview

Despite a normal or higher bone mass, type 2 diabetes is associated with a higher risk of osteoporotic fractures. Besides a higher falls frequency the lower quality of diabetics bone plays the crucial role in this case. One of the factors affecting their fracture risk is a choice of antidiabetic treatment. So far, professional societies have warned before the thiazolidinediones use only, but gliflozines can be harmful for bone too. Metformin, sulfonylureas, GLP-1 agonists and DPP-4 inhibitors belong to the drugs without a negative effect on the fracture risk. The increased frequency of bone fractures in diabetics treated with insulin lies more in the fact that these patients suffer from diabetes longer, have more diabetic complications and are at a higher risk of hypoglycemia, which is associated with a higher frequency of falls. In individuals with a high fracture risk antidiabetic drugs without a negative effect on bones should be recommended.

Key words:
DPP–4 inhibitors – gliflozines – GLP–1 agonists – insulin – metformin – osteoporosis – sulfonylureas – thiazolidinediones – type 2 diabetes mellitus

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