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Study wrapper · #860

Lower fall and femoral fracture risks with semaglutide and tirzepatide compared with DPP-4 inhibitors in older adults with type 2 diabetes.

Chen HY, Wu JY, Chu YH, et al. Osteoporosis international. 2026.

Editor's note

A large retrospective cohort using TriNetX and propensity-score matching found semaglutide and tirzepatide associated with roughly halved femoral fracture risk and about a third lower fall risk versus DPP-4 inhibitors in older adults with type 2 diabetes. The effect sizes are consistent across both drugs and several subgroups, which strengthens the signal, but this is observational and residual confounding remains possible. Solid hypothesis-generating evidence for a musculoskeletal benefit beyond glucose control, not proof of causation.

Plain-language abstract

In a large records-based study of older adults with type 2 diabetes, those on semaglutide or tirzepatide had roughly half the risk of femoral fractures and about a third lower fall risk compared with a different diabetes drug class.