Review Addresses Optimal Care of Type 2 Diabetes and Osteoporosis

HealthDay News — Optimal management of coexisting type 2 diabetes (T2D) and osteoporosis should consider the scientific evidence, according to a review published online in the Journal of Clinical Endocrinology & Metabolism.

Stavroula A. Paschou, MD, PhD, from the National and Kapodistrian University of Athens in Greece, and colleagues conducted a systematic literature search for human studies to examine the effects of diabetes treatment on bone metabolism, and the effect of anti-osteoporotic medication on the incidence and control of T2D.

The researchers emphasized the importance of healthy diet and physical exercise prevention and treatment of both conditions. In the setting of coexisting disease, the preferred treatment options for T2DM are sulfonylureas, dipeptidyl peptidase-4 inhibitors, and glucagon-like peptide-1 receptor agonists, while strict targets should be avoided due to risks of hypoglycemia, falls, and fractures. 

To avoid hypoglycemia, insulin should be used with caution and with careful measures. Thiazolidinediones and canagliflozin should be avoided; other sodium-glucose cotransporter 2 inhibitors are less well-validated options. In hospitalized patients with T2D and fracture, insulin therapy is the preferred method of achieving glycemic control. The presence of T2D should not affect treatment and monitoring of osteoporosis.

“Patients with coexisting T2D and osteoporosis should be managed in an optimal way according to scientific evidence,” the authors wrote.

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Paschou SA, Dede AD, Anagnostis PG, Vryonidou A, Morganstein D, Goulis DG. Type 2 diabetes and osteoporosis: a guide to optimal management [published online June 21, 2017]. J Clin Endocrinol Metab. doi:10.1210/jc.2017-00042