Several studies suggest that there is an association between thiazolidinediones, a type of drug introduced in the 1990s to treat type 2 diabetes, and bone fracture. Thiazolidinediones are a class of drugs for type 2 diabetes that lower the blood sugar by increasing the sensitivity of cells to insulin.
For the current study, researchers searched a computerized record of clinical records from over 6 million patients registered at 400 general practice surgeries in the United Kingdom. They identified 1,819 individuals aged 40 years or older who had a recorded bone fracture and who had been prescribed a thiazolidinedione for diabetes at least once. They then conducted a self-controlled case-series study, a study that compares how often an event (in this case bone fracture) occurs in a population of people during the period when they are taking a particular medication (in this case a thiazolidinedione drug for diabetes) against the period when they are not taking that medication. Adjusting for age (as older people are at a higher risk of bone fracture), the researchers found that in the group of people identified nearly one and half times as many fractures occurred when diabetes patients were taking thiazolidinediones than when they were not taking these drugs. The increased risk of fracture was observed in both men and women and applied to a wide range of fracture sites on the body. The study also found that the risk of fracture increased as the duration of treatment with the diabetes drug increased.
The study results are in keeping with findings from recent trials that suggested a link between treatment of diabetes with thiazolidinediones and bone fracture. The researchers conclude that the results should be taken into consideration in the wider debate surrounding the possible risks and benefits of treatment of diabetes with thiazolidinediones.
References:
1. Douglas IJ, Evans SJ, Pocock S, Smeeth L (2009) The Risk of Fractures Associated with Thiazolidinediones: A Self-controlled Case-Series Study. PLoSMed 6(9): e1000154. doi:10.1371/journal.pmed.1000154.
