Metformin adherence is associated with lower risk of osteoporotic fracture among patients with advanced type 2 diabetes
Main finding · All-site fracturesResult — go to the resultAdjusted subdistribution hazard ratio 0.76 95 % CI 0.69–0.83Authors' conclusion
MET adherence was associated with lower fracture risk in older adults with T2DM, highlighting its potential role in fracture prevention.
Study context
- Population
- Patients aged ≥50 years with T2D initiating second-line oral antidiabetic therapy while continuing metformin (MET), no prior fractures; Taiwan, 2014–2020matched cohort
- Participants
- 76,022 patients
- Exposure
- MET adherence vs non-adherence
- MET adherencen = 38,011
- Non-adherencen = 38,011reference
- Outcome
- All-site fractures, accounting for the competing risk of death
Methodological detailsnationwide claims data, propensity score matching (1:1), competing risk regression
- Nationwide claims data
- Propensity score matching (1:1)
- Competing risk regression
Main finding
All-site fractures
Adjusted subdistribution hazard ratio
0.76
95 % CI 0.69–0.83
P < 0.001
MET adherencevs Non-adherence
aSHR 0.76 (95 % CI 0.69–0.83); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Fracture sites
- Consistent effects across fracture sites
Concurrent DPP-4i or SGLT2i use
- No additional benefit with concurrent DPP-4i or SGLT2i
Original publication
Metformin adherence is associated with lower risk of osteoporotic fracture among patients with advanced type 2 diabetes. Diabetes Res Clin Pract. Published 14 May 2025. doi:10.
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