In the journals: Study confirms link between certain diabetes drugs and fractures
For several years, concerns have been mounting about the safety of a class of drugs known as thiazolidinediones (TZDs), used to treat type 2 diabetes. In 2007, after research found a higher rate of heart failure among people who took the TZDs rosiglitazone (Avandia) and pioglitazone (Actos), the FDA required a "black box" warning label on these medications. Other studies have prompted further worries: a 43% higher risk of heart attack in people who took rosiglitazone, as well bone loss and fractures in people — particularly women — taking either rosiglitazone or pioglitazone.
TZDs work by activating a substance known as PPAR-gamma that is made in fat cells and makes cells more receptive to the effects of insulin, the hormone that controls blood sugar. (People with type 2 diabetes are resistant to insulin or don't make enough of it.) It turns out that PPAR-gamma activation also stifles the formation of new bone while speeding bone resorption (breakdown). The authors of the study believe this is why TZDs lead to bone loss.
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