Tuesday, May 13, 2008; HE08

DIABETES

THE QUESTION Studies have shown that people with diabetes face an increased risk for broken bones. Might this be related to the medication they take?

THIS STUDY analyzed data on 4,748 men and women (average age, 61) with Type 2 diabetes, in which the body does not produce enough insulin or use it efficiently to convert glucose into energy, creating sugar levels that are too high. Of this group, 3,778 took oral anti-diabetes drugs, and 1,020 had been treated for a fracture. People who had taken a class of drugs known as thiazolidinediones, commonly prescribed drugs that include Avandia (rosiglitazone) and Actos (pioglitazone), for at least a year were two to three times more likely to have broken a bone, mainly a wrist or hip, than were those who took no oral medication for diabetes. The longer people had taken the drugs, the greater their risk. No added risk was found for other oral anti-diabetes drugs.

WHO MAY BE AFFECTED? People taking medication for Type 2 diabetes, the most common type.

CAVEATS How the drugs might affect younger diabetics was not evaluated. The study suggested but did not prove that the drugs caused loss of bone mass, leading to breaks.

FIND THIS STUDY April 28 issue of Archives of Internal Medicine.

LEARN MORE ABOUT diabetes at http://www.diabetes.niddk.nih.gov and http://www.diabetes.org.

THE QUESTION Older people frequently take pills known as loop diuretics to reduce swelling and fluid retention or sometimes to treat high blood pressure. Might these drugs, which increase the amount of calcium excreted in urine, contribute to bone loss?

THIS STUDY analyzed data on 3,269 men (average age, 73); 265 of them took loop diuretics -- either furosemide (Lasix), bumetanide (Bumex) or torsemide (Demadex). The men's bone density was measured twice, five years apart. During that time, average bone density decreased for the entire group. But the annual rate of decline was twice as great among men who had taken loop diuretics occasionally, and 2 1/2 times greater among regular users, than among those who never took the drugs.

WHO MAY BE AFFECTED? Older men who take loop diuretics, frequently prescribed for people with heart failure and liver disease. Men generally don't lose bone density as early as women, but by their late 60s, men and women lose bone mass at the same rate.

CAVEATS Whether the findings apply to women was not determined; they do not apply to other types of diuretics.

FIND THIS STUDY April 14 issue of Archives of Internal Medicine.

THE QUESTION For older women, bisphosphonates reduce the chances of broken bones from osteoporosis, a bone-thinning disease. But does this type of medication carry heart risks?

THIS STUDY analyzed data on 1,685 women, most in their 70s. About 5 percent of the women were taking Fosamax (alendronate), a bisphosphonate, or had taken it at some time, and 719 of them had received a diagnosis of atrial fibrillation, an abnormal heart rhythm. Women who had ever taken the drug were nearly twice as likely to have the heartbeat problem as were those who had never taken the medication.

WHO MAY BE AFFECTED? Older women taking Fosamax, generally to stave off the consequences of osteoporosis. Bisphosphonates are the most commonly prescribed drugs for this purpose.

CAVEATS Whether the findings apply to other bisphosphonates or to men was not determined.

FIND THIS STUDY April 28 issue of Archives of Internal Medicine.

-- Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.