A large study linked GLP-1 drugs to a 21% lower risk of fragility fractures in adults with type 2 diabetes.
Researchers analyzed health records from more than 133,000 people who started either a GLP-1 drug or another diabetes medication.
The findings are promising, but researchers say more studies are needed to determine whether GLP-1 drugs actually protect bones.
GLP-1 medications have become widely used for managing type 2 diabetes and, in some cases, helping people lose weight.
But that weight loss has raised an important question: Could losing weight quickly make bones more vulnerable to fractures?
A new study from UCLA Health offers some encouraging news. Researchers found that adults with type 2 diabetes who started taking a GLP-1 receptor agonist had a lower risk of experiencing a fragility fracture over three years than those who started a different type of diabetes medication.
Fragility fractures can happen after relatively minor trauma, such as a fall from standing height, and are often associated with underlying bone weakness.
How researchers studied the question
The researchers used electronic health records from the TriNetX Research Network, a large U.S. database. They looked at adults ages 50 to 90 with type 2 diabetes who newly started either a GLP-1 receptor agonist or a dipeptidyl peptidase-4 inhibitor, commonly called a DPP-4 inhibitor.
The study ultimately compared 133,606 people, with 66,803 patients in each group after researchers matched the groups based on characteristics that could affect their fracture risk. The participants were followed for up to three years.
“Fractures are relatively uncommon, so very large studies are needed to detect a meaningful difference,” researcher Dr. Christopher Hamad said in a news release. “Most previous studies were too small or were not designed to answer this question, and having data from more than 133,000 patients allowed us to better understand how GLP-1 medications may affect fracture risk and bone health.”
Researchers also examined whether changes in body mass index and blood sugar levels could explain the difference in fracture risk. A separate analysis compared fracture outcomes among people with and without type 2 diabetes.
What the results mean for consumers
Over the three-year study period, people who started a GLP-1 drug had a 21% lower risk of fragility fractures than those who started a DPP-4 inhibitor. The biggest reductions were seen in fractures involving the spine, hip, and femur.
The researchers also found that the lower fracture risk remained even after accounting for changes in body weight and blood sugar levels. That suggests the potential connection between GLP-1 drugs and bone health may involve more than simply weight loss or improved diabetes control.
Still, there is an important caveat: This was a retrospective observational study, so it can identify an association but cannot prove that GLP-1 medications themselves prevent fractures. The researchers say prospective studies are needed to establish whether the drugs have a protective effect on bones and to better understand their long-term impact on skeletal health.