The effect of long-term use of pioglitazone on bone mineral density in patients with diabetes mellitus

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Aims: This study aimed to explore the incidence of osteoporosis in patients with diabetes mellitus (DM) who have been on a long-term pioglitazone regimen, and to ascertain the link between pioglitazone usage and the onset of osteoporosis. Methods: We enrolled patients prospectively and conducted a comparative analysis between two groups of DM patients: those who had been using pioglitazone for a period exceeding two years, and those with no history of pioglitazone use. Bone Mineral Density (BMD) was assessed using dual energy X-ray absorptiometry (DEXA). Results: There were no significant differences in age, gender, disease duration, fasting plasma glucose levels, and HbA1c levels between pioglitazone users and non-users. However, a significant variation was found in the BMD measurements. Patients on pioglitazone had an L1-L4 vertebra BMD T-score of -1.3, compared to -0.9 in non-users (p