Adults with Type 2 diabetes who initiated glucagon-like peptide-1 receptor agonists had a 21% lower risk of fragility fractures over three years than those who started dipeptidyl peptidase-4 inhibitors, according to a study published July 24 in JAMA.
Researchers at UCLA and collaborating institutions analyzed EHR data from 133,606 adults with Type 2 diabetes. The greatest reductions were observed for vertebral fractures and hip or femur fractures.
Mediation analyses also found the lower fracture risk persisted independent of changes in body mass index and hemoglobin A1c, suggesting the association may not be explained by weight loss or glycemic control alone.
The authors cautioned that the study was observational and does not establish causality. They said prospective studies are needed to determine whether GLP-1 receptor agonists directly reduce fracture risk and to better understand their long-term effects on bone health.
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