Sulfonylureas use and fractures risk in elderly patients with type 2 diabetes mellitus: a meta-analysis study

Aging Clin Exp Res. 2021 Aug;33(8):2133-2139. doi: 10.1007/s40520-020-01736-4. Epub 2020 Oct 26.

Abstract

Background and aims: Sulfonylureas are widely used in patients with type 2 diabetes; meanwhile, the increasing fractures risks especially in the old are gradually taken into consideration. This meta-analysis aimed at investigating whether sulfonylureas could influence the risk of fractures in type 2 diabetes (T2DM) in the elder patients (≥ 65 years old).

Methods: We searched the PubMed and other databases to screen eligible studies. Two authors independently extracted data according to the selection criteria for each study. The Newcastle-Ottawa scale was used to evaluate the quality. Subgroups and sensitivity analyses were performed and publication bias was assessed.

Result: A total of 7 studies involving 464,121 individuals were included in our meta-analysis. The pooled risk ratio for developing fracture in sulfonylurea users with type 2 diabetes (≥ 65 years old) was 1.26 (95% CI 1.15-1.39). Sensitivity analyses confirmed the stability of the results and there was no publication bias.

Conclusions: Sulfonylureas could add the risk of fractures among the old with type 2 diabetes. Initial sulfonylureas therapy in both men and women should be done prudently.

Keywords: Elder people; Fracture risk; Meta-analysis; Sulfonylureas; Type 2 diabetes.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Fractures, Bone* / chemically induced
  • Fractures, Bone* / epidemiology
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Male
  • Sulfonylurea Compounds / adverse effects

Substances

  • Hypoglycemic Agents
  • Sulfonylurea Compounds