ArticleExperimental and therapeutic medicine2019
Insulin use and fracture risk in patients with type 2 diabetes: A meta-analysis of 138,690 patients.
Article in Experimental and therapeutic medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Impact of Different Anti-Hyperglycaemic Treatments on Bone Turnover Markers and Bone Mineral Density in Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2024Pooled it
- The use of metformin, sulfonylurea compounds and insulin and the risk of hip fractures in diabetic patients: a systematic review and meta-analysis of observational studies.BMC musculoskeletal disorders · 2023 · on this mapPooled it
- Association between combined treatment with SGLT2 inhibitors and metformin for type 2 diabetes mellitus on fracture risk: a meta-analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020 · on this mapPooled it
- Adjusting fracture probability according to duration of diabetes: the Manitoba BMD Registry.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Managing Bone Fragility in Older Adults with Diabetes: Pathophysiology, Assessment, and Therapeutic Considerations.Drugs & aging · 2026Review
- Incidence and risk factors for osteoporosis in people with type 2 diabetes mellitus in Thailand.BMC endocrine disorders · 2026Article
- Evaluation of bone health and fracture risk in type 2 diabetes: a network meta-analysis of anti-diabetic treatments versus placebo.Archives of pharmacal research · 2025Article
- Hypoglycemic agents and bone health; an umbrella systematic review of the clinical trials' meta-analysis studies.Diabetology & metabolic syndrome · 2024Review
- Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes.International journal of molecular sciences · 2023Observational
- The incidence of fractures at various sites in newly treated patients with type 2 diabetes mellitus.Bone reports · 2022Article
- Diabetes and bone.Archives of endocrinology and metabolism · 2022Review
- A Closed-Loop Autologous Erythrocyte-Mediated Delivery Platform for Diabetic Nephropathy Therapy.Nanomaterials (Basel, Switzerland) · 2022Article
- To do one and to get more: Part I. Diabetes and bone.Journal of the Chinese Medical Association : JCMA · 2022Review
- Hypoglycaemic therapy in frail older people with type 2 diabetes mellitus-a choice determined by metabolic phenotype.Aging clinical and experimental research · 2022Review
- Fracture Patterns in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review of Recent Literature.Current osteoporosis reports · 2021Review
- Hydroxycoumarin Scopoletin Inhibits Bone Loss through Enhancing Induction of Bone Turnover Markers in a Mouse Model of Type 2 Diabetes.Biomedicines · 2021Article
- Type 2 Diabetes Mellitus and Vertebral Fracture Risk.Current osteoporosis reports · 2021Review
- Impact of Diabetes Mellitus on Bone Health.International journal of molecular sciences · 2019Review
- Bone health in diabetes and prediabetes.World journal of diabetes · 2019Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with type 2 diabetes mellitus (T2DM) have been reported to have an enhanced risk of bone fracture, however the association between insulin treatment and risk of fracture in patients with T2DM remains to be fully elucidated. The aim of the present meta-analysis was to examine the possible association between insulin treatment and risk of fracture in patients with T2DM. Relevant studies published prior to and including April 2018 were identified by literature searches in PubMed, Embase and Cochrane Library databases. A meta-analysis was performed, which included relevant trials of patients with T2DM comparing insulin to oral anti-diabetic drugs. The combined effect was expressed as a pooled risk ratio (RR) with 95% confidence interval (CI), using a random-effects model. Subgroup analysis was performed to consolidate the results. A total of 7 studies comprising 138,690 patients were eligible for inclusion in the present meta-analysis. After exclusion of one study that introduced major heterogeneity, treatment with, insulin was associated with a significantly increased risk of fracture among patients with T2DM (RR=1.24, 95% CI, 1.07-1.44; P=0.004). Subgroup analysis by sex indicated that the RR for men was 1.04 (95% CI, 0.76-1.44, P=0.801) and that for women was 1.22 (95% CI, 0.92-1.62, P=0.175). Subgroup analysis by fracture site indicated that the RR for hip was 1.18 (95% CI, 0.83-1.68, P=0.363), that for vertebrae was 1.28 (95% CI, 0.90-1.81, P=0.169) and that for non-vertebrae was 1.06 (95% CI, 0.80-1.41, P=0.686). Subgroup analysis by study design suggested that the RR for prospective and retrospective studies was 1.35 (95% CI, 1.06-1.71, P=0.014) and 1.16 (95% CI, 0.99-1.35, P=0.059), respectively. Subgroup analysis by region indicated that the RR for Europe was 1.16 (95% CI, 0.91-1.48, P=0.220), that for North America was 1.24 (95% CI, 0.81-1.90, P=0.333) and that for Asia was 1.34 (95% CI, 0.91-1.98, P=0.141). In conclusion, treatment with insulin increased the risk of fractures among patients with T2DM compared with oral anti-diabetic drugs; however, the association was influenced by various factors, including sex, fracture site, study design and geographical region.
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