It seems like every other day, a new side effect is reported for one medication or another. A recent study found an increased risk of bone fractures in women taking a common class of diabetes medicine, called thiazolidinediones (TZD), used to help people with diabetes control their blood sugar.

This development has the potential to affect millions of women. The number of people with diabetes in the United States and worldwide continues to increase. According to the most recent statistics, 23 million Americans have the disease—almost 8% of the population. That number continues to rise, with 1.6 million new cases being diagnosed every year.

Over the past two years there have been numerous reports that TZDs may have negative effects on bone health. Specifically, they seem to decrease the ability to form new bone, while the rate of bone loss remains the same. Unfortunately, these medications are prescribed in patients with diabetes who, because of the disease, are already at increased risk for fracture.

The only way to definitively determine whether these medications do increase fracture risk is by randomized clinical trials. Until the trials are performed, it’s especially important for anyone taking these medications to minimize their fracture risk. Preventive steps include a healthy diet with plenty of calcium-rich foods and vitamin D supplements, and weight-bearing exercises to keep bones healthy. A baseline bone density scan should also be considered, to see if you’re particularly at risk for fracture.

No medication is without the risk of side effects. There can also be interactions between different medications, vitamins, and other supplements, so it’s important for your physician to have a complete list of what you’re taking. The benefits of treatment should always outweigh the potential risks, and there should be a careful discussion between physician and patient every time a new medication is started.

One final thought: Studies have shown that lifestyle changes, including exercise, weight loss, and the right diet are more effective than any medication we have for treating diabetes. And even small changes can make a big difference.

Naina Sinha, M. D., is Assistant Professor of Medicine, Endocrinology, Diabetes & Metabolism, New York Presbyterian Hospital and Weill Medical College of Cornell University. She is a member of the WVFC Medical Advisory Board.

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