GLP-1 medications may reduce the risk of serious fractures for adults with type 2 diabetes, according to research released by UCLA Health on Aug. 4.
Adults with type 2 diabetes and obesity face a high risk of fragility fractures, which are often caused by low-energy trauma such as falling from standing height and typically result from underlying bone weakness. There has been ongoing debate about whether rapid weight loss from GLP-1 receptor agonists could further weaken bones and increase fracture susceptibility.
The UCLA study, published in JAMA Network Open, analyzed electronic health records from nearly 134,000 U.S. adults between ages 50 and 90 who have type 2 diabetes. The researchers compared the fracture risk among new users of GLP-1 receptor agonists to those starting another common diabetes medication known as DPP-4 inhibitors.
Researchers found that use of GLP-1 receptor agonists was associated with a 21% lower risk of fragility fractures over a three-year period compared to DPP-4 inhibitor users. The most significant reductions were observed in hip, femur, and spine fractures. A separate analysis showed that this reduced risk was only present among participants with type 2 diabetes when compared to a matched group without diabetes.
"Fractures are relatively uncommon, so very large studies are needed to detect a meaningful difference," said Dr. Christopher Hamad. "Most previous studies were too small or were not designed to answer this question, and having data from more than 133,000 patients allowed us to better understand how GLP-1 medications may affect fracture risk and bone health."
The authors emphasized that their findings come from a retrospective observational study and do not prove that GLP-1s reduce fracture risk. They said prospective and translational studies are necessary to confirm the mechanisms involved and assess long-term effects on bone health.
