Alendronate may reduce risk for type 2 diabetes
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Alendronate, a drug commonly used to treat osteoporosis, may help protect against type 2 diabetes, according to a presenter at the European Association for the Study of Diabetes virtual meeting.
In a nationwide case-control study conducted in Denmark, people who used alendronate were less likely to have type 2 diabetes compared with those who never used the medication, with risk even lower for longer duration of use.
Rikke Viggers, MD, a PhD student at Steno Diabetes Center North Jutland, Aalborg University Hospital in Denmark, said more research is needed to learn about how alendronate might prevent type 2 diabetes.
“We do not know the mechanism of action and if this even exists — we need more clinical trials,” Viggers told Healio. “However, it is possible that alendronate impacts directly in peripheral cells, for example, a direct action on adipose and muscle tissue. It is also likely that the effect is driven indirectly by the known alteration of bone cells by alendronate. This will change secretion and release of bone metabolites that are potential actors in insulin sensitivity and glucose metabolism.”
Viggers and colleagues conducted a nested case-control study using data from the National Patient Registry, Health Service Prescription Registry and Central Person Registration System in Denmark. Researchers identified 163,588 people with type 2 diabetes between 2008 and 2018. Each person with diabetes was matched by age and sex with three random health controls. Data on alendronate use and the length of effective use were also collected.
After adjusting for confounders, participants using alendronate were significantly less likely to have type 2 diabetes compared with people who never used the drug (adjusted OR = 0.64; 95% CI, 0.62-0.66). The odds for type 2 diabetes decreased for those who used alendronate for a longer period. People taking alendronate for more than 8 years had a 53% lower risk for type 2 diabetes compared with nonusers (aOR = 0.47; 95% CI, 0.4-0.56). Researchers found an association between a longer use of alendronate and lower risk for type 2 diabetes (P = .002).
Viggers noted the findings must be confirmed in clinical trials before discussing clinical implications or making any recommendations for changes in guidelines. Researchers are currently conducting a clinical trial to assess whether alendronate can improve glucose metabolism and insulin sensitivity for people with diabetes.
“We need to perform randomized, placebo-controlled clinical trials including people with and without diabetes as well as people at higher risk of developing diabetes,” Viggers said. “It could be beneficial to include high-quality analyses, such as insulin clamp, tissue biopsies and bone markers before and after alendronate treatment, to investigate if and where the effect of alendronate is located.”
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Viggers R, et al. Alendronate use and risk of type 2 diabetes: A Danish population-based case-control study. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 27-Oct. 1, 2021 (virtual meeting).
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