Recent research has found that in older patients with Type 2 diabetes, the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors is associated with increased cardiovascular benefits but also reduced glycaemic control, whereas glucagon-like peptide 1 (GLP-1) receptor agonists show the opposite effect, with better glycaemic control but less cardiovascular protection.
Current clinical guidelines do not recommend different diabetes treatment approaches on the basis of sex or age groups, highlighting the uncertainty caused by the underrepresentation of women and older individuals in trials. As a result, Researchers conducted a network analysis to examine whether the efficacy of SGLT2 inhibitors, GLP-1 receptor agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors in controlling blood sugar levels or offering cardiovascular protection varied according to age and sex among adult patients with T2D.
The analysis included 601 eligible trials, of which 103 provided individual participant data.
In the study, the use of SGLT2 inhibitors was found to be associated with reduced lowering of HbA1c levels with increasing age. In contrast, the use of GLP-1 receptor agonists was linked to greater lowering of A1c levels with increasing age. The use of DPP-4 inhibitors led to slightly better lowering of HbA1c levels among older people for dual therapy, but not for monotherapy or triple therapy.
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