INS and Insulin resistance: One study on an experimental mouse model of OA investigated the effect of metformin, a potent first-line treatment used to increase insulin sensitivity in patients with insulin resistance, diabetes and obesity, as a possible disease-modifying agent in OA, and found that the combination of metformin and alendronate, a bisphosphonate with anti-resorptive properties used in the treatment of osteoporosis, led to a decrease in the degree of cartilage degradation [56].