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Review assesses best treatments for osteoporosis and type 2 diabetes

The combination of osteoporosis and type 2 diabetes has been the focus of a recent study review in Greece.
Osteoporosis occurs when bones become less dense and are more likely to fracture. Research has shown that people who have type 2 diabetes are more likely to suffer fractures.
In the past, researchers have focused on both conditions separately, but a team from the National and Kapodistrian University of Athens wanted to look at the best medications for those who need to control the conditions together.

To collect the data on medications, the team systematically reviewed previous studies and guidelines in a bid to help them develop recommendations for the best joint treatment options.
Dr Stavroula A. Paschou, who led the review, said: “Metformin, sulphonylureas, DPP-4 inhibitors and GLP-1 receptor agonists – medications for T2D – should be the preferred treatment for T2D in patients who also have osteoporosis.”
The team discovered those medications protect the bones, but thiazolidinediones (TZDs) and canagliflozin should be avoided and it was suggested insulin should be administered with caution.
Key journals and abstracts in the fields of diabetes, osteoporosis and endocrinology were also studied manually to ensure the very latest research in both conditions was taken into account.
No evidence was discovered which might suggest common osteoporosis medications affected glucose metabolism. Despite that, the researchers said “avoiding strict targets for blood glucose levels is important for jointly managing T2D and osteoporosis for the fear of hypoglycemia, falls and fractures.”
The authors added: “Insulin therapy is the preferred method for achieving glycemic control in hospitalized patients with T2D and fracture(s). The treatment and monitoring of osteoporosis should be continued without important amendments because of the presence of T2D.
“Patients with co-existing T2D and osteoporosis should be managed in an optimal way according to scientific evidence.”
The review was published in The Journal of Clinical Endocrinology and Metabolism.

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