29 Sept 2023 • A Korean nationwide cohort study published in JAMA aimed to investigate whether sodium-glucose cotransporter 2 inhibitors (SGLT2i) pose an increased risk of fractures in postmenopausal individuals with type 2 diabetes, a population already at higher risk for bone fragility.

• The study, conducted from 2013 to 2020, included individuals aged 45 or older with type 2 diabetes who were new users of either SGLT2i, dipeptidyl-peptidase 4 inhibitors (DPP4i), or glucagon-like peptide 1 receptor agonists (GLP1RA).
• The primary outcome was the occurrence of overall fractures, including vertebral, hip, humerus, and distal radius fractures.
• The results revealed that SGLT2i use was not associated with an increased risk of fractures when compared separately to DPP4i or GLP1RA.
• In fact, the study found that SGLT2i users had either similar or even lower risks of fractures when compared to these incretin-based drugs.
• These findings suggest that, in a high-risk population of postmenopausal individuals with type 2 diabetes, SGLT2i may not elevate the risk of fractures and could potentially be a suitable treatment option.

In conclusion, this population-based cohort study provides reassuring evidence that SGLT2 inhibitors do not appear to increase the risk of fractures in postmenopausal individuals with type 2 diabetes when compared to commonly used incretin-based drugs, DPP4 inhibitors, and GLP1 receptor agonists

Source: JAMA | Read full story