GLP-1 drugs such as Ozempic may reduce the risk of serious bone fractures in people with type 2 diabetes, according to a large study that challenges concerns that these increasingly popular medications could negatively affect bone health.
Researchers found that patients starting GLP-1 therapy had a 21% lower risk of fragility fractures over three years than a comparable group taking DPP-4 inhibitors, another class of diabetes medications.
People with type 2 diabetes face an increased risk of fractures from low-energy trauma, such as a fall from standing height or less, even though their bone mineral density is often normal or even above normal. This “may be related to reduced bone strength, impaired bone microarchitecture and accelerated bone loss,” the researchers noted.
After analyzing medical records from more than 133,000 American adults aged 50 to 90 with type 2 diabetes between 2015 and 2022, the researchers found that GLP-1 users experienced the largest reductions in vertebral fractures, by 32%, and fractures of the hip or femur, by 30%.
Importantly, the lower fracture risk was not associated with changes in body weight or blood glucose levels, suggesting that the medications could have a direct effect on bone tissue, Euronews reports.
The findings challenge long-standing concerns that rapid weight loss could increase fracture risk by reducing bone density. However, the researchers emphasize that the study does not prove that GLP-1 drugs protect bone health. Because the analysis was based on observational medical data rather than a randomized clinical trial, other factors—including physical activity, muscle strength and participants’ initial bone health—could have influenced the results.
The study also found no protective effect among people taking GLP-1 drugs without type 2 diabetes, suggesting that the findings may not apply to those using these medications solely for weight management.
The authors say prospective clinical trials are now needed to determine whether the lower fracture risk reflects a genuine biological effect of GLP-1 drugs and whether the benefit persists with longer-term treatment.
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