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Are Antiresorptive Drugs Effective Against Fractures in Patients with Diabetes?

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Abstract

We studied whether the reduction in bone turnover by use of antiresorptive drugs is detrimental in patients with diabetes who already have low bone turnover due to hyperglycemia in a nationwide cohort study from Denmark. All users of antiresorptive drugs against osteoporosis between 1996 and 2006 (n = 103,562) were the exposed group, with three age- and gender-matched controls from the general population (n = 310,683). Patients on bisphosphonates and raloxifene had a higher risk of hip, spine, and forearm fractures. However, no difference was observed in the antifracture efficacy between patients with diabetes and nondiabetic controls or between patients with type 1 and type 2 diabetes. Too few were users of strontium to allow analysis for this compound. The excess risk of fractures among patients treated with bisphosphonates or raloxifene compared to nonexposed controls was due to the higher a priori risk of fractures among patients treated for osteoporosis. Diabetes does not seem to affect the fracture-preventive potential of bisphosphonates or raloxifene. The low-turnover state of diabetes thus does not seem to be a hindrance to the effect of these drugs against osteoporosis. Therefore, patients with diabetes should receive treatment for osteoporosis in the same way as nondiabetic patients.

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Acknowledgments

This study was funded by an unrestricted grant from Servier Denmark and the Dandy Foundation. None of the sponsors had any role in obtaining data, analyzing data, or writing the report.

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  1. The Osteoporosis Clinic, Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus C, Denmark

    Peter Vestergaard, Lars Rejnmark & Leif Mosekilde

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  1. Peter Vestergaard
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  2. Lars Rejnmark
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Correspondence to Peter Vestergaard.

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The authors have stated that they have no conflict of interest.

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Vestergaard, P., Rejnmark, L. & Mosekilde, L. Are Antiresorptive Drugs Effective Against Fractures in Patients with Diabetes?. Calcif Tissue Int 88, 209–214 (2011). https://doi.org/10.1007/s00223-010-9450-4

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  • DOI: https://doi.org/10.1007/s00223-010-9450-4

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