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Abstract

Context:

Evidence suggests that the human skeleton might be involved in the regulation of glucose homeostasis.

Objective:

The objective of the study was to investigate the effect of exposure to bisphosphonates on the risk of incident type 2 diabetes mellitus (T2DM).

Design:

This was a population-based, retrospective, open cohort study over the period 1995–2010.

Setting:

The study was conducted from The Health Improvement Network database from the United Kingdom in a primary care setting.

Patients:

A total of 35 998 individuals aged older than 60 years, without diabetes at baseline and with more than 1 year's exposure to bisphosphonates, and 126 459 age-, gender-, body mass index- and general practice-matched unexposed individuals participated in the study.

Interventions:

There were no interventions.

Main Outcome Measure:

A new diagnosis of T2DM during the 16-year-long observation period, determined by Read codes and adjusted incidence rate ratio in bisphosphonate-exposed compared with unexposed groups, was the main outcome measure.

Results:

The risk of incident T2DM was significantly lower in patients exposed to bisphosphonates compared with matched controls [adjusted incidence rate ratio 0.52, 95% confidence interval (CI) 0.48–0.56, P < .0001]. In subgroup analyses, the findings remained consistent in males [0.77 (95% CI 0.66–0.89)], females [0.49 (95% CI 0.45–0.53)], obese [0.54 (95% CI 0.50–0.59)], individuals exposed to steroid treatment [0.47 (95% CI 0.34–0.64)], and over different types of bisphosphonate medication. Analysis of duration of treatment suggested a brief increase in the risk of T2DM (1 to 2.5 y of exposure), followed by a progressive, sustained decrease as the years of exposure accumulated.

Conclusions:

This observational evidence suggests exposure to bisphosphonates was associated with a significant 50% reduction in the risk of incident T2DM.

Copyright © 2015 by the Endocrine Society
Issue Section:
Original Articles
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