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 Table of Contents    
LETTER TO THE EDITOR
Year : 2022  |  Volume : 54  |  Issue : 1  |  Page : 65-66
 

Reducing Risk of Type 2 Diabetes Mellitus with Alendronate – A Promising Possibility for the Indian Population


Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India

Date of Submission24-Oct-2021
Date of Decision10-Dec-2021
Date of Acceptance17-Jan-2022
Date of Web Publication18-Mar-2022

Correspondence Address:
Dr. Amrit Mishra
Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry - 607 402
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijp.ijp_828_21

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How to cite this article:
Balaji A, Boratne AV, Mishra A. Reducing Risk of Type 2 Diabetes Mellitus with Alendronate – A Promising Possibility for the Indian Population. Indian J Pharmacol 2022;54:65-6

How to cite this URL:
Balaji A, Boratne AV, Mishra A. Reducing Risk of Type 2 Diabetes Mellitus with Alendronate – A Promising Possibility for the Indian Population. Indian J Pharmacol [serial online] 2022 [cited 2022 Dec 6];54:65-6. Available from: https://www.ijp-online.com/text.asp?2022/54/1/65/339916




Dear Editor,

With great interest, we read the research article on “Impact of oral anticholinergic on insulin response to oral glucose load in patients with impaired glucose tolerance” published in the 4th issue, 53rd volume of your esteemed Journal in 2021, contributed by Dr. Sandeep Lahiry, Dr. Mitali Chatterjee, and Dr. Sudip Chatterjee. The research findings showed the influence of parasympathetic cholinergic system on insulin secretion and the positive effect of oral anticholinergics in controlling impaired glucose tolerance.[1] Similarly, we would like to bring to your kind attention a promising possibility for reducing the likelihood of type 2 diabetes mellitus (T2DM) in the Indian scenario. Our article revolves around the potential of alendronate, a bisphosphonate used in treating osteoporosis, in reducing the risk of T2DM.

Currently, India has become the second-largest country with diabetic population. The Indian population is more prone to T2DM due to a multitude of modifiable and nonmodifiable factors such as ethnicity, family history, urbanization, nutritional shift from multigrain diets to fast foods, sedentary lifestyle, and obesity. Furthermore, the consequences of long-standing T2DM are quite debilitating. It is a known fact that Indians are scattered across many countries worldwide. Thus, the higher prevalence of T2DM among Indians will project a negative global effect on society, health care, and economy.[2]

Osteoporosis is another major health concern around the globe, including India. Its burden is negatively influenced by factors such as female predisposition, aging, and lifestyle changes. It develops with a decrease in bone mineral density or when the quality or structure of bone changes. One of the most commonly used drugs to treat this disease is bisphosphonates. They effectively inhibit bone resorption in osteoporotic patients while having lesser adverse effects.[3]

The prevalence of both these diseases in the Indian scenario has led us to gather the data pertaining to alendronate, a bisphosphonate, in reducing of risk of T2DM. Several studies in this regard have been conducted in other countries. A Danish prospective cohort study showed that the people taking alendronate had a reduced chance of developing T2DM. However, this study did not explore the association between osteoporosis and T2DM.[4] This limitation was removed by Chan et al. in their cohort study in Taiwan. Their study showed that the osteoporotic patients prescribed with alendronate had a significant reduction in developing T2DM. However, they noted that this protective effect of alendronate became less significant in older patients and the presence of comorbidities such as dyslipidemia or hypertension, prompting further research on the topic.[4]

To further corroborate, an Iranian triple-blind randomized clinical trial concluded that the use of alendronate improves glucose tolerance and insulin sensitivity and stabilizes insulin resistance in prediabetic, osteopenic, postmenopausal women.[5]

Further research is advocated to specifically study the potential of alendronate in reducing T2DM risk in the Indian population, comprising both the osteoporotic patients and the general population of different age groups and gender. The various factors affecting its mechanisms in minimizing T2DM risk need to be identified. The success of such a study will pave the way to better treatment regimens, thereby reducing the burden of T2DM in our country.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lahiry S, Chatterjee M, Chatterjee S. Impact of oral anticholinergic on insulin response to oral glucose load in patients with impaired glucose tolerance. Indian J Pharmacol 2021;53:294-7.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Ranasinghe P, Jayawardena R, Gamage N, Sivanandam N, Misra A. Prevalence and trends of the diabetes epidemic in urban and rural India: A pooled systematic review and meta-analysis of 1.7 million adults. Ann Epidemiol 2021;58:128-48.  Back to cited text no. 2
    
3.
Drake MT, Clarke BL, Khosla S. Bisphosphonates: Mechanism of action and role in clinical practice. Mayo Clin Proc 2008;83:1032-45.  Back to cited text no. 3
    
4.
Chan DC, Yang RS, Ho CH, Tsai YS, Wang JJ, Tsai KT. The use of alendronate is associated with a decreased incidence of type 2 diabetes mellitus – A population-based cohort study in Taiwan. PLoS One 2015;10:e0123279.  Back to cited text no. 4
    
5.
Karimi Fard M, Aminorroaya A, Kachuei A, Salamat MR, Hadi Alijanvand M, Aminorroaya Yamini S, et al. Alendronate improves fasting plasma glucose and insulin sensitivity, and decreases insulin resistance in prediabetic osteopenic postmenopausal women: A randomized triple-blind clinical trial. J Diabetes Investig 2019;10:731-7.  Back to cited text no. 5
    




 

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