This review summarizes the complex relationship between medications used to treat type 2 diabetes and bone health. T2DM patients face an increased fracture risk despite higher bone mineral density; thus, we analyzed the impact of key drug classes, including Metformin, Sulphonylureas, SGLT-2 inhibitors, DPP-4 inhibitors, GLP-1 agonists, and Thiazolidinediones. Metformin, despite promising preclinical results, lacks a clear consensus on its role in reducing fracture risk. Sulphonylureas present conflicting data, with potential neutral effects on bone. SGLT-2 inhibitors seem to have a transient impact on serum calcium and phosphorus, but evidence on their fracture association is inconclusive. DPP-4 inhibitors emerge as promising contributors to bone health, and GLP-1 agonists exhibit positive effects on bone metabolism, reducing fracture risk. Thiazolidinediones, however, demonstrate adverse impacts on bone, inducing loss through mesenchymal stem cell effects. Insulin presents a complex relationship with bone health. While it has an anabolic effect on bone mineral density, its role in fracture risk remains inconsistent. In conclusion, a comprehensive understanding of diabetes medications’ impact on bone health is crucial. Further research is needed to formulate clear guidelines for managing bone health in diabetic patients, considering individual profiles, glycemic control, and potential medication-related effects on bone.

This review summarises the complex relationship between medications used to treat type 2 diabetes, and bone health. T2DM patients face an increased fracture risk despite higher bone mineral density, thus we analysed the impact of key drug classes, including Metformin, Sulphonylureas, SGLT-2 inhibitors, DPP-4 inhibitors, GLP-1 agonists, and Thiazolidinediones. Metformin, despite promising preclinical results, lacks a clear consensus on its role in reducing fracture risk. Sulphonylureas present conflicting data, with potential neutral effects on bone. SGLT-2 inhibitors seem to have a transient impact on serum calcium and phosphorus, but evidence on their fracture association is inconclusive. DPP-4 inhibitors emerge as promising contributors to bone health, as well as GLP-1 agonists exhibit positive effects on bone metabolism, reducing fracture risk. Thiazolidinediones, however, demonstrate adverse impacts on bone, inducing loss through mesenchymal stem cell effects. Insulin presents a complex relationship with bone health. While it has an anabolic effect on bone mineral density, its role in fracture risk remains inconsistent. In conclusion, a comprehensive understanding of diabetes medications' impact on bone health is crucial. Further research is needed to formulate clear guidelines for managing bone health in diabetic patients, considering individual profiles, glycemic control and potential medication-related effects on bone.

Background: Vitamin D plays a crucial role in numerous physiological systems, including the muscular, immune, and endocrine systems, as well as calcium and bone homeostasis. Vitamin D deficiency, a global health problem affecting billions of people, is associated with adverse health outcomes and can serve as a marker for health status, disease severity, and length of hospital stay (LOS). Nutritional supplementation has been shown to be highly beneficial and is strongly recommended. Methods: In this study, the medical records of 834 hospitalized patients were retrospectively analyzed, with a focus on 25-hydroxyvitamin D [25(OH)D] levels. The patients were divided into groups based on serum vitamin D levels: deficient, suboptimal, adequate, and high. Correlations between vitamin D levels, LOS, laboratory parameters, comorbidities, seasonal variations, medical diagnosis of deficiency, and supplementation were examined. Results: Vitamin D deficiency was common and associated with a longer LOS. Women had higher vitamin D levels than men. No seasonal variation was observed. Only 14% of the patients took supplements before hospitalization, and 61% of the patients with vitamin D deficiency received supplementation. Conclusions: Routine vitamin D screening, tailored supplementation, and increased public awareness are essential to reduce hospitalizations, improve treatment outcomes, and promote independence among at-risk groups.