A new study analyzing health records from several hundred thousand people in Denmark has identified a link between low rates of type 2 diabetes and osteoporosis patients treated with a drug called alendronate. The researchers hypothesize the drug may prevent the development of insulin resistance.
Doctors have long recognized the link between osteoporosis and diabetes. Both type 1 and type 2 diabetics are known to be at a higher risk of osteoporosis-related fractures, but exactly why this is the case is still unclear.
Rikke Viggers, from Denmark’s Aalborg University Hospital, set out to investigate this relationship between the two diseases by looking at the rates of diabetes in those receiving active treatment for osteoporosis. Inspired by animal studies suggesting glucose regulation is potentially improved by some osteoporosis drugs, Viggers and colleagues analyzed health records from over half a million people.
The research focused on a drug called alendronate, from a class of medicines called bisphosphonates. These drugs are used to treat osteoporosis by slowing the breakdown of bone tissue.
After accounting for a number of confounding factors – including obesity, income and smoking – the researchers found rates of type 2 diabetes were 34 percent lower in those who had taken alendronate compared to those who hadn’t. The study also found the longer a person had been taking alendronate the less risk they faced from developing type 2 diabetes. It is estimated those on the medication for over eight years were 53 percent less likely to develop diabetes compared to those not taking the drug.
The new findings have yet to be published in a peer-reviewed journal, however, they were presented at the recent 57th Annual Meeting of the European Association for the Study of Diabetes. Several similar older studies certainly back up these new findings.
A large population-based cohort study published in 2015 tracked the incidence of type 2 diabetes in a number of people in Taiwan, while another Danish investigation from a decade ago conducted a similar investigation. Both studies found associations between lower rates of diabetes and alendronate use for osteoporosis.
The underlying mechanism explaining how alendronate could influence glucose metabolism or lower the risk of diabetes is still unclear. One hypothesis suggests alendronate could prevent the development of insulin resistance by reducing levels of oxidative stress and low-grade inflammation. However, more research will need to be done to prove this hypothesis either way.
In the short-term Viggers does not propose drugs such as alendronate should be directly prescribed to patients with diabetes as a front-line treatment. But she does propose doctors consider the potential broader benefits of these drugs when dealing with osteoporosis patients.
“Type 2 diabetes is a serious lifelong condition that can lead to other serious health issues such as stroke, heart disease, blindness and limb amputation and anything that prevents, or even delays it, will also reduce a person’s risk of all these other conditions,” says Viggers. “Excitingly, our research suggests that alendronate, an inexpensive medicine widely used to treat osteoporosis, may also protect against type 2 diabetes. We believe that doctors should consider this when prescribing osteoporosis drugs to those with pre-diabetes or at high risk of type 2 diabetes.”
Source: Diabetologia