Recommendations on the effect of antidiabetic drugs in bone

Endocrinol Diabetes Nutr. 2017 Mar:64 Suppl 1:1-6. doi: 10.1016/j.endinu.2016.11.001. Epub 2017 Feb 16.
[Article in English, Spanish]

Abstract

Objective: To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture.

Participants: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology.

Methods: The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND "osteoporosis", "fractures", "bone mineral density", "bone markers", "calciotropic hormones". Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group.

Conclusions: The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk.

Keywords: Antidiabetic drugs; Bone; Bone markers; Bone metabolism; Bone mineral density; Calciotropic hormones; Densidad mineral ósea; Fracturas; Fractures; Fármacos antidiabéticos; Hormonas calciotropas; Hueso; Marcadores óseos; Metabolismo óseo; Osteoporosis.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Aged
  • Bone Remodeling / drug effects
  • Bone Resorption / chemically induced
  • Bone Resorption / prevention & control
  • Contraindications, Drug
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Female
  • Fractures, Spontaneous / epidemiology
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / prevention & control*
  • Glucagon-Like Peptide 1 / agonists
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / pharmacology*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / adverse effects
  • Insulin / pharmacology
  • Insulin / therapeutic use
  • Male
  • Metformin / pharmacology
  • Metformin / therapeutic use
  • Middle Aged
  • Osteoporosis / complications
  • Osteoporosis / drug therapy
  • Osteoporosis / prevention & control
  • Randomized Controlled Trials as Topic
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • Sulfonylurea Compounds / adverse effects
  • Sulfonylurea Compounds / pharmacology
  • Sulfonylurea Compounds / therapeutic use
  • Thiazolidinediones / adverse effects
  • Thiazolidinediones / pharmacology
  • Thiazolidinediones / therapeutic use

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • Insulin
  • Sodium-Glucose Transporter 2 Inhibitors
  • Sulfonylurea Compounds
  • Thiazolidinediones
  • Glucagon-Like Peptide 1
  • Metformin