Sulfonylureas use and fractures risk in elderly patients with type 2 diabetes mellitus: a meta-analysis study

Background and aims Sulfonylureas are widely used in patients with type 2 diabetes; meanwhile, the increasing fractures risks especially in the old are gradually taken into consideration. This meta-analysis aimed at investigating whether sulfonylureas could influence the risk of fractures in type 2 diabetes (T2DM) in the elder patients (>= 65 years old). Methods We searched the PubMed and other databases to screen eligible studies. Two authors independently extracted data according to the selection criteria for each study. The Newcastle-Ottawa scale was used to evaluate the quality. Subgroups and sensitivity analyses were performed and publication bias was assessed. Result A total of 7 studies involving 464,121 individuals were included in our meta-analysis. The pooled risk ratio for developing fracture in sulfonylurea users with type 2 diabetes (>= 65 years old) was 1.26 (95% CI 1.15-1.39). Sensitivity analyses confirmed the stability of the results and there was no publication bias. Conclusions Sulfonylureas could add the risk of fractures among the old with type 2 diabetes. Initial sulfonylureas therapy in both men and women should be done prudently.

Automated summary

This meta-analysis found that the use of sulfonylureas in elderly patients with type 2 diabetes aged 65 and older increases the risk of fractures. Sensitivity analysis confirmed the stability of the results and no publication bias was detected.