Recommendations on the effect of antidiabetic drugs in bone

Abstract Objective To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture. Participants Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Methods The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND “osteoporosis”, “fractures”, “bone mineral density”, “bone markers”, “calciotropic hormones”. Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group. Conclusions The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk.