GLP-1 drugs linked to lower fracture risk in adults with type 2 diabetes

by University of California, Los Angeles

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New research by UCLA Health has found GLP-1 medications may reduce the risk of serious fractures for adults with type 2 diabetes.

Adults with type 2 diabetes and obesity have a high risk of fragility fractures, which are caused by low-energy trauma, such as falling from standing height, and are often the result of underlying bone weakness.

While GLP-1 receptor agonists can significantly reduce weight among users, there has been debate about whether rapid weight reduction could further weaken bones and make them more prone to fractures.

The new UCLA study, published in JAMA Network Open, used electronic health records from nearly 134,000 U.S. adults ages 50–90 with type 2 diabetes to compare the fracture risk of new GLP-1 users with that of new users of another common diabetes medication, DPP-4 inhibitors.

Researchers found that GLP-1 receptor agonist use was associated with a 21% lower risk of fragility fractures over the three-year study period compared with DPP-4 inhibitor use, with the largest reductions occurring in fractures of the hip, femur and spine. A separate analysis found that the reduced risk was associated only with participants with type 2 diabetes, compared with a matching cohort of participants without diabetes.

"Fractures are relatively uncommon, so very large studies are needed to detect a meaningful difference," said Dr. Christopher Hamad. "Most previous studies were too small or were not designed to answer this question, and having data from more than 133,000 patients allowed us to better understand how GLP-1 medications may affect fracture risk and bone health."

The authors noted that the findings come from a retrospective observational study and do not prove that GLP-1s reduce fracture risk. Prospective and translational studies are needed to confirm their mechanistic impacts and long-term effects on bone health.

Publication details

Christopher D. Hamad et al, Glucagon-Like Peptide-1 Receptor Agonists and Fragility Fracture Risk in Type 2 Diabetes, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.25141

Journal information: JAMA Network Open

Key medical concepts

Diabetes Type 2Dipeptidyl-Peptidase IV Inhibitors

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EndocrinologyOrthopedicsHealthy aging Provided by University of California, Los Angeles Who's behind this story?

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