GLP1R and Insulin resistance: Negative effects on bone health in patients with T2DM are attributed to reduced bone formation via hyperglycemia and insulin resistance [16] DPP-4 inhibitors may affect bone health by improving hyperglycemia as antihyperglycemic agents that extend the half-life of incretin hormones such as glucagon like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) [17].