Fractures in Diabetics

Fracture risk in postmenopausal women associated with use of thiazolidinedione diabetes drugs.
HealthDay (7/29, Gardner) reported that Avandia [rosiglitazone] and Actos [pioglitazone], "two widely prescribed diabetes drugs, may raise the risk of broken bones in postmenopausal women with type 2 diabetes," according to a study published online July 14 and to appear in the October issue of the Journal of Clinical Endocrinology & Metabolism. In addition, there was "a fracture risk seen among men who had been prescribed either Avandia or Actos plus a loop diuretic," but not with the drugs individually. HealthDay noted, "This isn't the first time such an association has been seen, raising doubts as to whether these drugs, which belong to the class of medications known as thiazolidinediones (TZDs), should be the first choice for treating type 2 diabetes."
"For the new study, researcher William H. Herman, MD, MPH, professor of medicine and epidemiology at the University of Michigan, Ann Arbor, evaluated a large database of managed care patients who had diabetes," WebMD (7/29, Doheny) reported. "He found that those who suffered fractures were more likely to be taking the class of drugs known as TZDs (thiazolidinediones), such as Actos and Avandia." Notably, "'diabetic women over 50 with fractures were 70% more likely to be taking a TZD drug than women without fractures,' he" stated.
MedPage Today (7/29, Bankhead) reported, "Among diabetic men with a history of fractures, concurrent use of a TZD and a loop diuretic was more than three times as common as in similar men with no history of fractures." The study authors noted that "fracture risk was associated with TZD dose, but the risk was similar for rosiglitazone and pioglitazone, suggesting a class effect." MedPage Today noted that the "study was funded by the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases."