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Review question / Objective: To determine the association between bisphosphonate use and the risk of incident diabetes and glycemic control in adults with updated evidence from clinical trials and observational studies. Eligibility criteria: The inclusion criteria for studies assessing risk of incident diabetes are as follows: (1) availability of data on bisphosphonate use in individuals without diabetes; (2) evaluation of the risk of diabetes for bisphosphonate users compared with controls; and (3) either clinical trials or observational studies. To assess effects of bisphosphonates on glycemic control, we will include studies with: (1) availability of data on bisphosphonate use in individuals regardless of diabetes state; (2) evaluation of the glycemic parameters, including fasting blood glucose (FBG) or glycosylated hemoglobin (HbA1c), for bisphosphonate users compared with controls; (3) report sufficient data on the change in glycemic parameters (FBG and HbA1c) before and after bisphosphonate use or placebo/comparison use; (4) either clinical trials or observational studies. We will exclude studies with only a single arm without comparison.

Association of Bisphosphonates with Risk of Incident Diabetes and Glycemic Control: A Protocol of Systematic Review and Meta-analysis