Impact of different hypoglycemic treatments on bone mineral density of men with type 2 diabetes mellitus. Preliminary study.

Austin Texas

Congreso; Annual Meeting of the American Society for Bone and Mineral Research; 2022

American Society for Bone and Mineral Research

Impact of different hypoglycemic treatments on bone mineral density of men with type 2 diabetes mellitus. Preliminary study.Authors: María R. Ulla, Lucas R. Brun, Mauro Pautasso, María L. Brance, María J. Castro, Florencia Martos, Daniela Porta, Santiago Mazzini, Elena Peralta López, María A. Rivoira.Introduction: It has been shown that type 2 diabetes mellitus (DM2) negatively affects bone. Patients with longer duration of DM2 and poorer glycemic control, have higher risk of hip fracture, despite having normal bone mineral density (BMD). Besides, the treatments to normalize glycemia could affect bone differently. Our objective was to evaluate BMD in men with DM2 undergoing treatment with insulin glargine (IG), oral hypoglycemic agents (OHA) and combined treatment (IG+OHA). Materials and methods: Cross-sectional study including twenty-nine men with DM2, treated with IG (n=13), OHA (n=9) or combined treatment (n=7). None of the patients suffered from any phosphocalcic metabolic disease, had had any fracture or had been treated with osteoactive drugs, calcium or vitamin D. BMD was measured in total hip, femoral neck and lumbar spine. Glycemia, glycosylated hemoglobin (HbA1c), creatinine, glomerular filtration rate (GFR), body mass index (BMI), calcium, phosphorus, vitamin D and alkaline phosphatase were determined. Satistics: ANOVA and Bonferroni test. Results: patient age and BMI were similar in all groups, age (years): IG: 61.8±9.9; OHA: 69.8±10.9; IG+OHA: 61.3±5.9; BMI (kg/m2): IG: 29.6±4.1; OHA: 28.4±2.4; IG+OHA: 31.7±4.5. The time since DM2 diagnosis was 13.5±8.6 years. There were no differences in the glycemia, creatinine, GFR, calcemia, phosphatemia and total alkaline phosphatase in the three groups. All patients had insufficient vitamin D (less than 29 ng/mL). HbA1c was higher in the group under IG (IG: 9.1±0.9; OHA: 8.0±0.9; IG+OHA: 7.8±1.5%, p<0.05). This group also presented lower BMD: Hip BMD (g/cm2): GI: 0.790±0.070, OHA: 0.994±0.151 and GI+OHA: 0.989±0.093, p<0.005; Femur BMD (g/cm2): GI: 0.678±0.055; OHA: 0.868±0.128; IG+OHA: 0.875±0.108, p<0.005; Lumbar spine BMD (g/cm2): IG: 0.843±0.096; OHA: 1.050±0.175; IG+OHA: 1.095±0.126). In conclusion, patients treated with IG alone had poor glycemic control, which could be associated with lower BMD in these patients. Evaluating BMD and phosphocalcic metabolism in this population could prevent future complications.