Grant: CIHR Fellowship

Type-2 diabetes mellitus (T2DM) and osteoporosis are two of the most common chronic diseases worldwide with significant health challenges. Osteoporosis is a brittle bone disease that results in devastating fractures due to low bone density. While T2DM patients have normal bone density, research shows that these patients have a high number of fractures resulting from a simple fall. Thus, while there are treatments for osteoporosis to reduce fractures, these medications may not work in patients with T2DM who do not have low bone density. There is therefore a need to identify new treatment options that will reduce fractures in T2DM patients. There is some evidence that bone strength, rather than density, may be reduced in T2DM patients, and this may account for the high rate of fractures. A new class of anti-diabetic drugs (incretins) may improve overall bone quality and strength, and this may in turn result in fewer fractures. However, further research of the ability of these drugs to improve bone strength and reduce fractures in T2DM patients is needed. To examine the effect of incretins on bones the research proposed will address two main questions: 1) do incretins increase bone strength? and 2) do patients who take incretins have fewer fractures? First, the effect of incretins on bone strength will be examined using new imaging technology in a group of T2DM patients in the Netherlands. Second, the effectiveness of incretins on reducing the number of fractures will be examined in T2Dm patients in the UK and Denmark. This research is the first step towards improving the quality of life of patients with T2DM by identifying a treatment option that will improve diabetes symptoms and reduce fractures. By examining data in three countries, this will be the largest research study to identify the effect of new anti-diabetic drugs on fractures. Results will be used to inform clinical practice guidelines on the management of fractures in patients living with T2DM.