Diabetes Drug Increases Risk For Bone Fractures in Older Women

A Henry Ford Hospital study finds women with type 2 diabetes who take a commonly prescribed class of medications to treat insulin resistance may be at a higher risk for developing bone fractures. The study appears in The Journal of Clinical Endocrinology & Metabolism.

After taking a thiazolidinedione (TZD) for one year, women are 50% 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 and osteoporosis-related fractures, which might explain why they appeared to be the most affected by TZDs," says study senior author L. Keoki Williams, MD, MPH, of the Center for Health Services Research and department of internal medicine at Henry Ford Hospital.

To determine the relationship between TZD use and fracture risk in patients with type 2 diabetes, Williams and his colleagues conducted a retrospective study from January 2, 2000, to May 31, 2007, of 19,070 Henry Ford 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 fill 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 upper extremity and distal lower extremity. Similar findings were observed in treated women older than 65, who were shown to have a 70% increased risk for developing fractures. Men, regardless of age, were not at an increased risk for fractures.

"Fractures are just one of a growing number of problems associated with these medications. Henry Ford and other researchers have previously found that this class of medications also can increase risk of congestive heart failure hospitalization," says Williams.

— Source: Henry Ford Health System