A new study shows that menopausal women with diabetes are at increased risk of fracture when taking thiazolidinediones, including pioglitazone and rosiglitazone. According to the study, men with diabetes also had an increased risk of fracture when taking both a medullary diuretic and a thiazolidinedione. ”Our study demonstrated that the increased risk of fracture was associated with high doses of TZD, and that pioglitazone is no different from rosiglitazone, clearly a class of TZD drugs that affect fracture risk.” The senior author of this study, William Herman of the University of Michigan in Ann Arbor, said. ”Internal medicine physicians should be aware of this hazard and weigh the pros and cons of treatment when initially prescribing or re-prescribing for TZDS.” He added. The data applied came from the Investigational Activity Study in Diabetes (TRIAD), a multicenter prospective observational diabetes care study in managed care, in which investigators administered a corresponding case-control study to evaluate whether fractures occurred in patients with type 2 diabetes taking different doses of TZD. From this study, the investigators identified 786 fracture events and 2657 corresponding controls (diabetic patients without fractures). When compared with their corresponding control group, women with fractures at age 50 and older would be more likely to have applied a high dose of the prescription drug TZDS. Men with fractures were more likely to have taken the prescription medication pelvic diuretics and drugs when compared with their corresponding control group. This result was particularly intriguing because men, using either medullary diuretics or thiazolidinediones alone, were unable to develop significant harm. ”Further studies, especially long-term, prospective randomized clinical trials, should be needed to conclusively demonstrate that small doses de-modulate harm,” Herman said. This new study was accepted for publication in the Endocrine Society’s Clinical Journal of Endocrinology and Metabolism.