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GLP-1 therapy may help reduce fracture risk among adults with type 2 diabetes

New research by UCLA Health found GLP-1 medications may reduce the risk of serious fractures for adults with type 2 diabetes. Adults with type 2 diabetes and obesity have a high risk of fragility fractures, which are caused by low-energy trauma such as falling

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New research by UCLA Health found GLP-1 medications may reduce the risk of serious fractures for adults with type 2 diabetes.

Adults with type 2 diabetes and obesity have a high risk of fragility fractures, which are caused by low-energy trauma such as falling from standing height and are often the result of underlying bone weakness.

While GLP-1 receptor agonists can significantly reduce weight in users, there has been debate on whether rapid weight reduction could further weaken bones and make them more prone to fractures.

The new UCLA study, published in JAMA Network Open, used electronic health records of nearly 134,000 U.S. adults, ages 50-90, with type 2 diabetes to compare fracture risk of new users of GLP-1s to new users of another common diabetes medication, DPP-4 inhibitors.

Researchers found that GLP-1 receptor agonist use was associated with a 21% lower risk of fragility fracture over the 3-year study period compared to DPP-4 users, with the largest reductions occurring in fractures of the hip, femur and spine. A separate analysis found that the reduced risk was only associated with type 2 diabetes participants compared to a matching cohort of non-diabetic participants.

Fractures are relatively uncommon, so very large studies are needed to detect a meaningful difference. Most previous studies were too small or were not designed to answer this question, and having data from more than 133,000 patients allowed us to better understand how GLP-1 medications may affect fracture risk and bone health." Dr. Christopher Hamad, UCLA Health

The authors noted that the findings come from a retrospective observational study and do not prove GLP-1s reduce fracture risk. Prospective and translational studies are needed to confirm their mechanistic impacts and long-term effects on bone health.

Hamad, C. D., et al. (2026) Glucagon-Like Peptide-1 Receptor Agonists and Fragility Fracture Risk in Type 2 Diabetes. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2026.25141. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2852068

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Related questions

01Why does diabetes increase peripheral artery complications?

Peripheral artery disease (PAD) is a progressive condition characterized by abnormal narrowing and blocking of blood vessels, which is associated with an increased risk of myocardial infarction, stroke, and cardiovascular disease-related mortality. The condition affects about 236 million individuals worldwide. The prevalence of PAD is particularly high among patients with type 2 diabetes, which makes these patients five times more likely to undergo an amputation and twice as likely to die, often at a younger age than people without diabetes. Considering the significant negative impact of PAD in diabetic patients, international clinical guidelines have recommended using glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) in individuals with type 2 diabetes and PAD to reduce the risk of major adverse cardiovascular events. This systematic review and meta-analysis of recent evidence aimed to evaluate the impact of GLP-1RAs on major limb events in individuals with type 2 diabetes and PAD. A total of two randomized clinical trials and ten cohort studies involving 418,282 participants with type 2 diabetes and PAD were included in the final analysis.

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