Diabetes drugs substantially increase risk of bone fractures

A new study has revealed that diabetes drug boosts bone fat and fracture risk and exercise can partially counterbalance the effect.

First author Maya Styner said that these drugs weren't first or second-line choices of treatment for type-2 diabetes but some patients do take them, adding that the doctors and patients need to better understand the relationship between diabetes, certain drugs and the often dramatic effect on bone health.

According to the study, rosiglitazone affects bone fat by enhancing a critical transcription factor called PPAR - peroxisome proliferator-activated receptor - which regulates the expression of specific genes in the nuclei of cells. Essentially, rosiglitazone takes glucose out of blood to lower blood sugar and treat diabetes. But that glucose is then packaged into lipid droplets - fat.

Styner said that many of her patients have been surprised to learn that some diabetes drugs can adversely affect bone health. She also said that diabetes itself can harm bones.

She said that more bone fat means less actual bone, which increases the risk of bone fractures and added that exercise might trigger marrow stem cells to create more bone cells instead of fat cells.

In the study, Styner's team added a running wheel to mouse cages. They measured the effects of running. Even on a high dose of a power drug, such as rosiglitazone, the mice that exercised showed a significant decrease in bone fat.

Styner further added that she would still advise patients at risk of declining bone health to find an exercise that suits them.

The study is published is the Journal Endocrinology.