Thiazolidinediones Increase Fracture Risk in Women

Two widely prescribed type 2 diabetes drugs have recently been shown to increase risk of fractures in women, following long-term usage.

A class of drugs known as thiazolidinediones, are commonly prescribed for type 2 diabetics, due to their ability to improve insulin resistance, and help control blood sugar levels. It’s estimated that about four million diabetics take thiazolidinediones in the United States alone. The two most common thiazolidinediones are rosiglitazone and pioglitazone, and both have now been connected to higher fracture rates in women through a comprehensive “meta-analysis,” which acquired data from 10 previous studies. Rosiglitazone was also recently shown to increase risk of heart disease, and other dangerous conditions, in elderly individuals of both sexes.

The study accounted for 13,715 type 2 diabetics, some taking one of the two common thiazolidinediones, others taking no such drug. It was found that women on these drugs long-term had decreased bone density in the spinal chord and the hip. It was concluded by the researchers that women taking thiazolidinediones were more than twice as likely to suffer fractures (one of of every 21 women), as opposed to type 2 diabetic women not taking thiazolidinediones (one out of every 55 women, approximately, suffer fractures in this group).

There are substitutes for thiazolidinediones, such as the even more popular drug metformin, which has similar effects. Researcher Dr. Yoon Loke reasons that “If one assumes that half of those users were women and that the baseline risk of fractures is similar to that found in the ADOPT study, an estimated 30 000 excess fractures may have occurred if these women had been prescribed thiazolidinediones rather than metformin for more than a year.” While the authors do not suggest that increased fracture risk is a totally justifiable reason to change treatment plans, the risks should be considered and evaluated, given the above evidence.

Source: Defeat Diabetes Foundation: Loke, Yoon. Barnhardt, Kim. Canadian Medical Association Journal news release. December 2008.