Diabetes and fracture healing: the skeletal effects of diabetic drugs

Abstract

Introduction: Over 39,000 diabetic patients are surgically treated for trauma and orthopaedic injuries annually in the UK, yet the effects of diabetic medications on the skeletal system is an under researched and under acknowledged field.

Areas covered: This review covers all English language novel experimental data reports investigating the effects of the main classes of diabetic drugs on the skeletal system, specifically their effects on fracture healing, located through the literature search engines Medline and Web of Science.

Expert opinion: Post-surgical gylcaemic control is paramount in insulin-controlled type 1 diabetic patients. Data on pharmacological control compounds used in type 2 diabetes are limited. Reports to date indicate thiazolidinediones to exert anti-osteogenic effects, in contrast to the observed osteogenic effects of biguanides. Ongoing research is desirable to guide future clinical recommendations.

Keywords:

• biguanide
• diabetes
• fracture (+/- healing)
• insulin
• metformin
• osteogenesis
• rosiglitazone
• thiazolidinedione

Notes

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