GLP-1 inhibitors linked to fracture risk in elderly diabetic patients, study finds

GLP-1 drugs like Ozempic and Wegovy have revolutionized the treatment of type 2 diabetes and obesity – but new research suggests doctors may need to pay more attention to bone health, especially in older patients taking the drugs.

Older adults with type 2 diabetes who started GLP-1s had an 11% higher risk of fragility fractures compared to those taking other diabetes medications, a study published in February in the Journal of Clinical Endocrinology & Metabolism found.

Dr. Michal Kasher Meron, an endocrinologist at Meir Medical Center in Israel and the lead author of the study, said the relative increase may sound small, but it carries weight for people at risk.

“Both age and type 2 diabetes are independent risk factors for fragility fractures,” Kasher Meron told Fox News Digital. “This is a population that deserves special attention.”

A fragility fracture is a break from a small fall or normal activity, often linked to osteoporosis, and can lead to hospitalization, loss of independence and even increased mortality in the elderly, Kasher Meron noted.

The study followed more than 46,000 adults aged 65 and over for nearly three years. After adjustment, GLP-1 users had a modest but statistically significant increase in fracture risk.

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Previous studies in young patients using older GLP-1s did not show an increased risk of fractures, but newer and more potent versions are now widely prescribed for adults, notes Kasher Meron.

“In older adults treated with modern medicine, the fracture risk picture looks different and needs attention,” he said.

A separate study found slightly higher rates of osteoporosis and gout in adults using GLP-1s. (Stock)

The study, however, was observational, meaning it showed an association but not causation. The researchers could not determine whether the risk was driven by weight loss, changes in diet, muscle loss, or a direct effect on bones.

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However, Kasher Meron says, “Bone health should be assessed before starting these medications in elderly patients – not as an afterthought.”

The findings come as separate research presented at the annual meeting of the American Academy of Orthopedic Surgeons this month raised further concerns about bone health.

In a large analysis of more than 146,000 adults with obesity and type 2 diabetes, GLP-1 users were found to have a 29% higher risk of osteoporosis over five years compared to non-users, according to reports.

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Rates of gout were also slightly higher, affecting 7.4% of GLP-1 users compared to 6.6% of non-users – about a 12% relative increase.

Experts recommend bone density testing for older adults taking GLP-1 medications. (Stock)

Osteomalacia, a softening of the bones, was rare but occurred about twice as often in GLP-1 users, according to the study, which has not yet been peer-reviewed. It was also a watch, showing the organization only. Fox News Digital has reached out to the researcher for comment.

There are many methods that can be used, experts say. GLP-1 drugs suppress appetite and can lead to rapid weight loss. Significant weight loss is known to reduce bone density, in part because less mechanical load is placed on the skeleton.

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“It’s the same idea we always hear about astronauts going up into space, and they’re in zero-gravity for a long time,” lead author Dr. John Horneff, associate professor of orthopedic surgery at the University of Pennsylvania, told NBC News. “There’s nothing forcing their bones to hold their weight. And a lot of those astronauts come back with low bone density.”

In addition, eating fewer calories can also mean less calcium, vitamin D and protein – nutrients that are important for strong bones.

GLP-1 drugs such as Ozempic and Wegovy are widely used to treat type 2 diabetes and obesity. (Stock)

Rapid weight loss can temporarily increase levels of uric acid, a byproduct of muscle breakdown, which may explain gout flare-ups.

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Despite these findings, experts say that the results should not prohibit the appropriate use of GLP-1 drugs, which have proven benefits for blood sugar control, weight loss and cardiovascular risk reduction.

In addition to bone density tests, experts say patients should ensure adequate nutrition and resistance training to help maintain muscle and bone during weight loss.

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A spokesperson for Novo Nordisk, which makes GLP-1 drugs, said the company prioritizes patient safety, works closely with the US Food and Drug Administration (FDA) and accepts independent research on its products.

Experts also recommend proper nutrition and resistance training to help maintain muscle and bone health during weight loss. (Stock)

The known risks and benefits of the drugs are reflected in the current FDA-approved labeling, Liz Skrbkova, head of US media relations at Novo Nordisk, told Fox News Digital. He stressed that semaglutide has shown benefits for the heart, kidneys and liver when used under medical supervision.

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“Osteoporosis is a complex condition that develops over many years due to risk factors,” said Skrbkova.

Melissa Rudy of Fox News Digital contributed reporting.

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