Novel incretin-based drugs, such as glucagon-like peptide-1 receptor agonists (GLP-1 RA) and dipeptidyl peptidase-4 inhibitors\r\n(DPP-4i), have been last introduced in the pharmacological treatment of type 2 diabetes. In the last few years, the interest on the\r\nrelationship of gut hormones with bone metabolism in diabetes has been increasing. The aim of present paper is to examine in\r\nvitro and in vivo evidence on the connections between incretin hormones and bone metabolism.We also discuss results of clinical\r\ntrials and metaanalysis, explore the effects of incretin drugs in vitro on osteogenic cells and osteoclasts, and speculate on the\r\npossibility of different effects of GLP-1 RA and DPP-4i on the risk of bone fractures risk in humans. Although existing preliminary\r\nevidence suggests a protective effect on the bone, at least for DPP-4i, further controlled, long-term studies with measurement of\r\nbone markers, bone density, and clinical fractures rates are needed to substantiate and confirm those findings.
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