Combined Treatment With SGLT2 Inhibitors and Metformin For Type 2 Diabetes Mellitus on Fracture Risk
Association between combined treatment with SGLT2 inhibitors and metformin for type 2 diabetes mellitus on fracture risk: a meta-analysis of randomized controlled trials
Osteoporos Int. 2020 Dec;31(12):2313-2320.Twenty-five randomized controlled trials including 19,500 patients with type 2 diabetes mellitus were included in this systematic review and meta-analysis comparing SGLT2 inhibitors combined with metformin vs. metformin monotherapy or other comparators. Pooled outcomes of interest included overall fracture risk, fracture location (hip/lumbar spine vs. other), drug-specific risk, follow-up duration, bone mineral density (BMD), and bone turnover markers (BTMs). No significant differences were observed in fracture risk, regardless of drug type, control regimen, fracture site, or follow-up time. These findings suggest that combining SGLT2 inhibitors with metformin does not increase fracture risk in patients with type 2 diabetes.
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