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Fosamax Boosts Bone in Older Women with Diabetes

Diabetic women treated with alendronate had increases in bone mineral density of the spine and hip and at all sites.

Fosamax, a drug used to increase bone mineral density in older women, works well for women with type 2 diabetes, according to a new report.

Older women with diabetes have an increased risk for fractures, so "preservation of bone mineral density is particularly important," Dr. Theresa H. M. Keegan, of Stanford University School of Medicine, California, and colleagues write in the medical journal Diabetes Care.

Fosamax, known technically as alendronate, has been tested in general populations of postmenopausal women, "but its effect is unknown in women with type 2 diabetes," the team points out.

To look into this, the researchers used data from the Fracture Intervention Trial to compare changes in bone mineral density during three years of alendronate treatment versus placebo in diabetic women.
The trial included 6458 women between the ages of 54 and 81 years with low bone density who were randomly assigned to take either an inactive placebo or a daily 5-milligram tablet of alendronate for two years, followed by 10 milligrams daily for the rest of the trial. A total of 297 women had type 2 diabetes.

Diabetic women treated with alendronate had increases in bone mineral density of the spine and hip and at all sites; women in the placebo group experienced only a slight increase in spine bone density, and decreases at all other sites.

These differences were similar to those seen in women without diabetes. "The safety/tolerability of alendronate was similar to placebo, except for abdominal pain, which was more likely in the alendronate group," Keegan and colleagues write.

They add that the number of women with diabetes in the trial was too small to determine if alendronate reduced the number of fractures, so "further studies may be needed to evaluate the antifracture effectiveness of alendronate in diabetic women with and without low bone mineral density."
Diabetes Care, July 2004.