Diabetic bone fragility through advanced glycation end product-collagen axis: Mechanisms and therapy of sodium glucose cotransporter 2 inhibitors

Table 6 Relative effects of common antidiabetic medications on fracture risk

Drug class	Effect estimates and 95%CI	Study type	Ref.
SGLT-2 inhibitors vs placebo	HR = 0.98 (95%CI: 0.70-1.37)	Randomized controlled trial	Perkovic et al[153]
SGLT-2 inhibitors vs DPP-4 inhibitors	HR = 0.90 (95%CI: 0.73-1.11)	Cohort study	Zhuo et al[17]
SGLT-2 inhibitors vs GLP-1 RAs	HR = 1.00 (95%CI: 0.80-1.25)	Cohort study	Zhuo et al[17]
GLP-1 receptor agonists vs placebo	OR = 1.27 (95%CI: 0.88-1.83)	Systematic review/network meta-analysis	Chai et al[157]
DPP-4 inhibitors vs placebo	RR = 1.44 (95%CI: 1.04-1.98)	Network meta-analysis	Tsai et al[159]
TZDs (e.g., pioglitazone) vs placebo	RR = 1.21 (95%CI: 1.01-1.45)	Systematic review/meta-analysis	Azhari and Dawson[162]

SGLT-2: Sodium-glucose cotransporter 2; DPP-4: Dipeptidyl peptidase-4; GLP-1 RA: Glucagon-like peptide-1 receptor agonist; TZD: Thiazolidinedione; CI: Confidence interval; HR: Hazard ratio; OR: Odds ratio; RR: Risk ratio.