Use of Alendronate Could Lower Odds of Developing Type 2 Diabetes

An analysis of patient data from a national registry in Denmark indicates use of alendronate was associated with reductions in odds of developing type 2 diabetes, with this reduction becoming greater with longer use of the osteoporosis medication.

An analysis of data from more than 160k patients with type 2 diabetes and nearly 500k matched controls indicates use of alendronate could provide a protective effect against development of type 2 diabetes.

The analysis, which leveraged data from the National Danish Patient Registry, found use of the osteoporosis medication was associated with a reduction in odds of developing type 2 diabetes, with odds of developing diabetes more than halved among those using alendronate for 8 years or longer.

“Type 2 diabetes is a serious lifelong condition that can lead to other serious health issues such as stroke, heart disease, blindness and limb amputation and anything that prevents, or even delays it, will also reduce a person’s risk of all these other conditions,” said Rikke Viggers, MBBS, of Aalborg University Hospital in Denmark, in a statement.

With observational studies and recent animal studies suggesting bisphosphonate use might influence glucose regulation, Viggers and a team of colleagues sought to determine whether this association would be observed in real-world practices. Presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), the study was designed as a population-based case-control study using ICD-10 codes from the National Danish Patient Registry and redeemed prescription data from the Health Service Prescription registry from 2008-2018.

For the purpose of analysis, investigators identified all patients with a diagnosis of type 2 diabetes during the aforementioned time frame and matched them based on sex and age to 3 randomly selected controls by incidence-density sampling. Investigators used conditional logistic regression analysis with adjustment for multiple confounding factors to calculate odds ratios for developing type 2 diabetes and exposure was defined as the first use of alendronate. Of note, alendronate use was further classified as effective and compliant use.

From their search, investigators identified 163,588 patients with type 2 diabetes and 490,764 matched controls for inclusion in their analysis. The mean age of this patient population was 67 years and 55% were male.

Upon analysis, the crude OR for development of type 2 diabetes following alendronate use was 0.93 and the adjusted OR was 0.64 (95% CI, 0.62-0.66). Further analysis indicated patients using alendronate for 8 years or longer had an OR of 0.47 for development of diabetes after adjustment for confounding factors. Investigators also pointed out a test for trend indicated a dose-response relationship existed between longer effective use of alendronate and lower risk of developing diabetes (P=.002). Investigators noted it is still unclear how alendronate might reduce risk of developing type 2 diabetes, but suggest it could be the result of reductions in low-grade inflammation and oxidative stress.

“Excitingly, our research suggests that alendronate, an inexpensive medicine widely used to treat osteoporosis, may also protect against type 2 diabetes,” Viggers added. “We believe that doctors should consider this when prescribing osteoporosis drugs to those with pre-diabetes or at high risk of type 2 diabetes.”

This study, “Alendronate use and risk of type 2 diabetes: a Danish population-based case-control study,” was presented at EASD 2021.