Introduction. Hypoglycemic drugs affect the bone quality and the risk of fractures in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and insulin on bone mineral density (BMD) in T2DM. Methods. In this single-blinded study, a total of 65 patients with T2DM were randomly assigned into four groups for 52 weeks: the exenatide group (
n
=
19
), dulaglutide group (
n
=
19
), insulin glargine group (
n
=
10
), and placebo (
n
=
17
). General clinical data were collected, and BMD was measured by dual-energy X-ray absorptiometry. Results. Compared with baseline, the glycosylated hemoglobin (HbA1c) decreased significantly in the exenatide (
8.11
±
0.24
%
vs.
7.40
±
0.16
%
,
P
=
0.007
), dulaglutide (
8.77
±
0.37
%
vs.
7.06
±
0.28
%
,
P
<
0.001
), and insulin glargine (
8.57
±
0.24
%
vs.
7.23
±
0.25
%
,
P
<
0.001
) groups after treatment. In the exenatide group, the BMD of the total hip increased. In the dulaglutide group, only the BMD of the femoral neck decreased (
P
=
0.027
), but the magnitude of decrease was less than that in the placebo group; the BMD of L1-L4, femoral neck, and total hip decreased significantly (
P
<
0.05
) in the placebo group, while in the insulin glargine group, the BMD of L2, L4, and L1-4 increased (
P
<
0.05
). Compared with the placebo group, the BMD of the femoral neck and total hip in the exenatide group and the insulin glargine group were increased significantly (
P
<
0.05
); compared with the exenatide group, the BMD of L4 in the insulin glargine group was also increased (
P
=
0.001
). Conclusions. Compared with the placebo, GLP-1RAs demonstrated an increase of BMD at multiple sites of the body after treatment, which may not exacerbate the consequences of bone fragility. Therefore, GLP-1RAs might be considered for patients with T2DM. This trial is registered with ClinicalTrials.gov NCT01648582.
Effects of Serum 25-Hydroxyvitamin D Level on Decreased Bone Mineral Density at Femoral Neck and Total Hip in Chinese Type 2 Diabetes v1 (protocols.io.kjycupw)
