GLP-1 drugs linked to bone fracture risk in older diabetes patients, study finds

GLP-1 drugs such as 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-1 therapy had an 11% increased risk of fragility fractures compared with those taking other diabetes medications, according to a study published in February in the Journal of Clinical Endocrinology & Metabolism.

D., an endocrinologist at Meir Medical Center in Israel and the study’s lead author. Michal Kasher Meron said the relative increase may seem small, but for an at-risk population it carries weight.

“Advanced 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.”

Fragility fractures are breaks that result from minor falls or routine activities and are often linked to osteoporosis and can lead to hospitalization, loss of independence and even increased mortality in older adults, Kasher Meron said.

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

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Kasher Meron noted that previous research in younger patients using older GLP-1s did not show an increased risk of fracture, but newer, stronger versions are now widely prescribed to older adults.

“The picture of fracture risk in older adults treated with contemporary medications looks different and requires close attention,” he said.

A separate study found slightly higher rates of osteoporosis and gout among adults taking GLP-1. (iStock)

However, the study was observational, meaning it showed a relationship, not causation. Researchers could not determine whether the risk was due to weight loss, changes in diet, muscle loss, or a direct effect on bone.

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However, Kasher Meron says, “Bone health should be evaluated in older patients before starting these medications—not as an afterthought.”

The findings come as a separate study presented this month at the annual meeting of the American Academy of Orthopedic Surgeons raises additional concerns about bone health.

According to reports, an analysis of more than 146,000 adults with obesity and Type 2 diabetes found that GLP-1 users had a 29% higher relative risk of osteoporosis over five years compared to non-users.

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Gout rates were also slightly higher; It affected 7.4% of GLP-1 users and 6.6% of non-users; a relative increase of approximately 12%.

Experts recommend bone density screening for older adults taking GLP-1 medications. (iStock)

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 observational and only showed a relationship. Fox News Digital has reached out to the investigator for comment.

Experts say several mechanisms may be at play. GLP-1 drugs suppress appetite and can cause rapid weight loss. Significant weight loss is known to reduce bone density, in part due to less mechanical load being placed on the skeleton.

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Lead author Dr., associate professor of orthopedic surgery at the University of Pennsylvania. “This is the same idea we hear about astronauts going into space and being in a zero-gravity environment for very long periods of time,” says John Horneff. he told NBC News.

“There’s nothing forcing their bones to support their weight anymore. And many of these astronauts come back with low bone density.”

Additionally, consuming fewer calories may also mean reduced intake of calcium, vitamin D and protein, which are critical for bone strength.

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

Rapid weight loss may also temporarily increase levels of uric acid, a byproduct of tissue breakdown, which may explain the increase in cases of gout.

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

In addition to bone density screening, experts say patients should receive adequate nutrition and resistance training to help preserve muscle and bones during weight loss.

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A spokesman for Novo Nordisk, which makes GLP-1 drugs, said the company prioritizes patient safety, works closely with the U.S. Food and Drug Administration (FDA) and welcomes independent research into its products.

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

Liz Skrbkova, Novo Nordisk’s head of U.S. media relations, told Fox News Digital that the drugs’ known risks and benefits are reflected in current FDA-approved labeling. He emphasized that semaglutide shows cardiovascular, kidney and liver benefits when used under medical supervision.

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“Osteoporosis is a complex condition that develops over many years as a result of interconnected risk factors,” Skrbkova said. he added.

Fox News Digital’s Melissa Rudy contributed reporting.

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