Type 2 Diabetes Thiazolidinediones Double the Risk of Fractures

January 7, 2009

thiazolidinediones Researchers have analyzed data from 10 randomized controlled trials involving 13 715 participants and from 2 observational studies involving 31 679 participants to determine the risk of fractures associated with thiazolidinedione therapy and to evaluate the effect of the therapy on bone density.

Thiazolidinediones are a class of drugs for type 2 diabetes that lower the blood sugar by increasing the sensitivity of cells to insulin.

Rosiglitazone and pioglitazone were associated with a significantly increased risk of fractures overall in the 10 randomized controlled trials.

Five randomized controlled trials showed a significantly increased risk of fractures among women.

The 2 observational studies demonstrated an increased risk of fractures associated with rosiglitazone and pioglitazone.

Bone mineral density in women exposed to thiazolidinediones was significantly reduced at the lumbar spine and hip in 2 randomized controlled trials.

The results of the research demonstrate long-term thiazolidinedione use doubles the risk of fractures among women with type 2 diabetes, without a significant increase in risk of fractures among men with type 2 diabetes.

Other contraindications to the use of thiazolidinediones include liver disease and heart failure.

1. Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009 Jan 6;180(1):32-9. PMID: 19073651.
2. Singh S, Loke YK, Furberg CD. Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA. 2007 Sep 12;298(10):1189-95. PMID: 17848653.
3. Singh S, Loke YK. The safety of rosiglitazone in the treatment of type 2 diabetes. Expert Opin Drug Saf. 2008 Sep;7(5):579-85. PMID: 18759710.

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