GLP-1 receptor agonists and the risk of fragility fractures in older adults with type 2 diabetes
Main finding · Fragility fractureResult — go to the resultHazard ratio 1.11 95% CI 1.01–1.21Authors' conclusion
Initiating GLP-1RA therapy was associated with a modestly increased risk of fragility fractures in older adults with type 2 diabetes. These findings may inform clinical decisions by balancing clinical benefits against potential skeletal risks in this vulnerable population.
Study context
- Population
- People with T2D aged ≥65 years initiating GLP-1 RA or comparator drugs 2018–2022, Clalit Health Services
- Participants
- 46,177 people
- Exposure
- GLP-1 RA vs SGLT2i or DPP-4i
- Outcome
- First fragility fracture
- Follow-up
- Median 34.7 months
Methodological detailsnationwide Clalit Health Services database, inverse probability of treatment weighting based on propensity scores, competing risk of death
- Nationwide Clalit Health Services database
- Inverse probability of treatment weighting based on propensity scores
- Competing risk of death
Main finding
Fragility fracture
Hazard ratio
1.11
95% CI 1.01–1.21
GLP-1RAvs Comparator
HR 1.11 (95% CI 1.01–1.21)
As reported in the abstract
- Increased fracture risk with GLP-1RA vs comparator
- 11%
- Overall fragility fracture
- 4086 (8.8%)
Observational data: associations, not effects.
Further findings
Death (overall cohort) · median follow-up 34.7 months
- Died
- 4595 (10.0%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
GLP-1 receptor agonists and the risk of fragility fractures in older adults with type 2 diabetes. J Clin Endocrinol Metab. Published 10 February 2026. doi:10.
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