Effect of Alendronate on Bone Mineral Density in Post Menopausal Women with Type 2 Diabetes Mellitus

Aim: To perform a retrospective study to determine the effect of Bisphophanates on bone mineral density (BMD) in the late post-menopausal (PM) osteoporatic and osteopenic women with Type 2 Diabetes Mellitus (DM). Method: In this retrospective case control study, 114 PM diabetic women over age 65 who took alendronate for at least 3 years, 43 of them had osteoporosis and 71 with osteopenia. The efficacy of therapy was measured by comparing a minimum of two BMD studies. Result: The study (n=114) demonstrated statistically significant BMD gain (+3.1% and +1.9%) at the spine and hip respectively but statistically significant loss of BMD (-9.8%) at forearm (FA). There was statistically significant correlation between body mass index (BMI) and BMD, in spine and hip but not in FA. We found negative correlation between A1C and BMD at all 3 sites, with a statically significant correlation observed at FA. Conclusion: It appears that Bisphosphonates are not effective in preventing bone loss in the FA of diabetic post-menopausal women. In addition bisphosphonates therapy resulted in significant gains of BMD at the spine and hip. A larger study should be done to compare bisphosphonates to other modalities of therapy for osteoporosis in diabetic post menopausal patients.