Diabetes & Metabolism · Jun 24, 2026

Decreased risk of new-onset osteoporosis in patients with Type 2 diabetes on SGLT-2 inhibitors

By Chang CF, Wang WY, Liao PL et al.

AIMS: To evaluate the risk of new-onset osteoporosis (NOO) associated with sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with type 2 diabetes (T2D). METHODS: This population-based cohort study used Taiwan's National Health Insurance Research Database. Participants were initially matched 1:2 on age, sex, and T2D duration between the SGLT2i and non-SGLT2i groups. Cox proportional hazards models assessed the association between SGLT2i use and the risk of NOO. Differences in osteoporosis risk over time between groups were also analyzed using the Kaplan-Meier method. A sensitivity analysis was then conducted using 1:1 propensity score matching. RESULTS: After matching on age, sex, and T2D duration, the study included 309,747 participants in the SGLT2i group and 619,494 in the non-SGLT2i group from 2016 to 2022. In the adjusted Cox model, SGLT2i use was associated with an 18% reduction in the risk of incident osteoporosis (adjusted hazard ratio [aHR]: 0.82, 95% confidence interval [CI]: 0.79-0.84). The sensitivity analysis using 1:1 propensity score matching included 274,329 patients per group, and SGLT2i use remained associated with a lower risk of osteoporosis (aHR: 0.83, 95% CI: 0.80-0.86). Kaplan-Meier analysis also showed that SGLT2i users had a lower incidence of NOO. CONCLUSION: In real-world settings, patients with T2D treated with SGLT2is had a lower risk of NOO than those not using SGLT2is.

doi.org/10.1016/j.diabet.2026.101778PubMed 42341919Populations