Biphosphonates use for osteoporosis may protect against incident diabetes

Taiwan: A study published in the Osteoporosis International journal has concluded that Patients on Biphosphonates (BPs) have a reduced risk of incident diabetes compared to those without BP.

It is already known that Biphosphonates (BPs) improve glycemic control. Osteoporosis and type 2 diabetes are emerging global health problems. These conditions are related to increased morbidity and mortality. There is an urgent need for the prevention and management of the disease.

Bisphosphonates like alendronate are the first-line treatment of osteoporosis. A study published in Frontiers in Endocrinology entitled "Alendronate Use and Risk of Type 2 Diabetes: A Nationwide Danish Nested Case-Control Study" has mentioned the protective effect of alendronate against type 2 diabetes development in a dose-dependent manner.

Considering this, a study was conducted by a team of researchers to evaluate the bisphosphonate impact on glycemic control and incident diabetes risk. The lead researcher was Dr Chen from the Department of Physical Medicine and Rehabilitation at  Hualien Tzu Chi Hospital.

The key study points are:

• The database used was MEDLINE, Embase, and Cochrane Library.

• The studies included comparing fasting blood glucose (FBG) and HbA1c levels and the risk of diabetes with and without bisphosphonates.

• Random effects models were used to calculate pooled RR and weighted mean difference (WMD).

• A total of Seven studies were included.

• There were two post hoc analyses of RCTs and five observational studies.

• The total number of participants was 1,233,844.

• BPs significantly reduced the risk of diabetes with an RR of 0.77 and a P value of 0.002 compared to the controls.

• In the subgroup of post hoc analyses , there was a non-significant association with an RR of 0.93 and a P value of 0.576.

• Three studies included 4906 participants on FBG, and one had 60 participants on HbA1c.

• There is a non-significant association between BPs and changes in FBG and HbA1c with WMD of − 0.61 mg/dL and − 0.11%, respectively.

• The P values were 0.567 and 0.083, respectively.

The researchers said that,

Patients with BPs have a reduced risk of incident diabetes compared to those without BPs. We warrant further investigations to investigate if the findings are causal.

Further reading:

Chen, PW., Su, HY., Tu, YK. et al. Association of bisphosphonates with diabetes risk and glycemic control: a meta-analysis. Osteoporos Int (2022).