Objective  To explore the effect of sitagliptin and metformin combined with zoledronic acid in the treatment of type 2 diabetes mellitus (T2DM) complicated with osteoporosis (OP) on the levels of glucose and lipid metabolism and bone metabolism in patients.

Methods  Patients with T2DM combined with OP admitted to Nantong Second People's Hospital from January 2021 to January 2024 were selected as the research subjects and randomly divided into the combined group (sitagliptin and metformin combined with zoledronic acid) and the control group (zoledronic acid only). After 6 months of treatment, the clinical efficacy, glucose and lipid metabolism indicators [fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], bone metabolism indicators [osteoprotegerin (OPG), bone-specific alkaline phosphatase (BALP), osteocalcin (OC)] levels, changes in bone density, and incidence of adverse reactions were compared between the two groups before and after treatment.

Results  A total of 120 patients were included, with 60 patients in each group. After treatment, the total effective rate of the combination group was 93.33%, significantly higher than the control group's 73.33% (P<0.05). The levels of FBG, 2hPG, HbA1c, TC, TG, and LDL-C in two groups were significantly lower than those before treatment, while the levels of HDL-C, OPG, BALP, OC, and bone density in the femoral neck and lumbar spine were significantly higher than before treatment (P<0.05); and all indicators of the combined group were better than those of the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05).

Conclusion  Sitagliptin and metformin combined with zoledronic acid in the treatment of patients with T2DM complicated with OP is more effective in regulating their glycolipid metabolism and bone metabolism levels, increasing bone density, improving therapeutic effects, and it has better safety than zoledronic acid  alone.

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