Impact of Antidiabetic Medications on Bone Remodeling Markers and Bone Structure in Type 2 Diabetic Wistar Rats

Abstract

Background: The presence of impaired bone quality in the presence of normal or even elevated bone mineral density (BMD) has been increasingly recognized as a feature of Type 2 diabetes mellitus (T2DM) and is thought to be due to changes in bone remodeling.

Objective: To assess the effect of the commonly used antidiabetic drugs on serum bone remodeling markers and bone histomorphometric structure in Wistar rats with type 2 diabetes mellitus.

Materials and Methods: The experimental animal study was conducted at Faisalabad Medical University Faisalabad, Punjab, from August 2023 to January 2024. The animals were divided into 6 equal groups of 10 animals each: Group I (Normal Control); Group II (Diabetic Control); Group III (Diabetic + Metformin); Group IV (Diabetic + Pioglitazone); Group V (Diabetic + Sitagliptin); Group VI (Diabetic + Insulin). SPSS version 25 was used for data analysis, and p-values <0.05 were considered statistically significant.

Results: Diabetic control rats had significantly lower levels of osteocalcin and higher levels of CTX than normal controls (p<0.001), suggesting reduced bone formation and enhanced bone resorption. The bone marker profile was least favorable in the pioglitazone group and most favorable in the Insulin and Metformin groups, indicating improvement toward normal control values.

Conclusion: Bone remodeling markers and bone microarchitecture were significantly altered in Wistar rats with untreated type 2 diabetes.