@article{791c42aaa0764a4f858fba1af0be884c,
title = "The effect of insulin on bone mineral density among women with type 2 diabetes: a SWAN Pharmacoepidemiology study",
abstract = "Summary: This was a longitudinal study examining the effects of insulin use on bone mineral density loss. Insulin use was found to be associated with greater bone mineral density loss at the femoral neck among women with diabetes mellitus. Introduction: Women with diabetes mellitus (DM) have higher bone mineral density (BMD) and experience slower BMD loss but have an increased risk of fracture. The data regarding the effect of insulin treatment on BMD remains conflicted. We examined the impact of insulin initiation on BMD. Methods: We investigated the annual changes in BMD associated with the new use of insulin among women with DM in the Study of Women{\textquoteright}s Health Across the Nation (SWAN). Propensity score (PS) matching, which is a statistical method that helps balance the baseline characteristics of women who did and did not initiate insulin, was used. Covariates with a potential impact on bone health were included in all models. Mixed model regression was used to test the change in BMD between the two groups. Median follow-up time was 5.4 years. Results: The cohort consisted of 110 women, mean age, 53.6 years; 49% white and 51% black. Women using insulin (n = 55) were similar on most relevant characteristics to the 55 not using insulin. Median diabetes duration for the user group was 10 vs. 5.0 years for the non-user group. There was a greater loss of BMD at the femoral neck among insulin users (− 1.1%) vs non-users (− 0.77%) (p = 0.04). There were no differences in BMD loss at the spine − 0.30% vs − 0.32% (p = 0.85) or at the total hip − 0.31% vs − 0.25 (p = 0.71), respectively. Conclusions: Women with T2DM who initiated insulin experienced a more rapid BMD loss at the femoral neck as compared to women who did use insulin.",
keywords = "Bone mineral density, Diabetes mellitus, Fracture, Insulin, Women",
author = "K. Ruppert and J. Cauley and Y. Lian and Zgibor, {J. C.} and C. Derby and Solomon, {D. H.}",
note = "Funding Information: Conflicts of interest Dan H. Solomon receives salary support from institutional research grants from Eli Lilly, Amgen, Pfizer, AstraZeneca, Genentech, and Corrona. He also receives royalties from UpToDate and serves in unpaid roles in studies funded by Pfizer and Eli Lilly. Kristine Ruppert, Jane Cauley, Yijuan Lian, Carol Derby, and Janice Zgibor declare they have no conflict of interest. Funding Information: Funding information The Study of Women{\textquoteright}s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the NIH Office of Research on Women{\textquoteright}s Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH. Clinical centers: University of Michigan, Ann Arbor—Siob{\'a}n Harlow, PI 2011–present, MaryFran Sowers, PI 1994–2011; Massachusetts General Hospital, Boston, MA—Joel Finkelstein, PI 1999–present, Robert Neer, PI 1994–1999; Rush University, Rush University Medical Center, Chicago, IL—Howard Kravitz, PI 2009–present, Lynda Powell, PI 1994–2009; University of California, Davis/Kaiser—Ellen Gold, PI; University of California, Los Angeles—Gail Greendale, PI; Albert Einstein College of Medicine, Bronx, NY—Carol Derby, PI 2011–present, Rachel Wildman, PI 2010–2011; Nanette Santoro, PI 2004–2010; University of Medicine and Dentistry—New Jersey Medical School, Newark—Gerson Weiss, PI 1994–2004; and the University of Pittsburgh, Pittsburgh, PA—Karen Matthews, PI. NIH program office: National Institute on Aging, Bethesda, MD— Chhanda Dutta 2016–present, Winifred Rossi 2012–2016, Sherry Sherman 1994–2012, Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD—Program officers. Central laboratory: University of Michigan, Ann Arbor—Daniel McConnell (Central Ligand Assay Satellite Services). Coordinating center: University of Pittsburgh, Pittsburgh, PA—Maria Mori Brooks, PI 2012–present; Kim Sutton-Tyrrell, PI 2001–2012; New England Research Institutes, Watertown, MA—Sonja McKinlay, PI 1995–2001. Publisher Copyright: {\textcopyright} 2017, The Author(s).",
year = "2018",
month = feb,
day = "1",
doi = "10.1007/s00198-017-4276-9",
language = "English (US)",
volume = "29",
pages = "347--354",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "2",
}
