Diabetes medications linked to slower progression of frailty in older adults

Diabetes medications linked to slower progression of frailty in older adults

New study shows benefits of certain diabetes medications for older adults

A new study shows that older adults with type 2 diabetes treated with sodium-glucose co-transporter-2 (SGLT-2) inhibitors such as empagliflozin (Jardiance) and dapagliflozin (Farxiga) or glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (Ozempic) and liraglutide (Victoza) have a slower rate Progression of frailty experienced over one year compared to those starting other diabetes medications. The results suggest that these therapies could help older adults maintain their strength, mobility and independence beyond the known positive effects on blood sugar and heart health.

What is frailty?

Frailty refers to a condition in which a person is weaker and less resilient. This can lead to older people getting tired more quickly, moving more slowly, or being more prone to falls and other health problems. Frailty is particularly dangerous because it often means that people are no longer able to be as active in everyday life and need more help.

The study with the title“Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes”, published inDiabetes care, studied older adults who had just started various diabetes medications and followed them over a year. It was found that people who took SGLT-2 inhibitors or GLP-1 medications were less likely to show signs of frailty, such as weakness, slow movements or fatigue, compared to those who took other diabetes medications. In other words, these treatments appear to help patients with diabetes maintain strength and function as they age. The benefit could not be fully explained by cardiac benefits, suggesting the drugs may directly help prevent frailty.

Study results in detail

By analyzing a national sample of 7% of Medicare claims in the U.S., researchers tracked one-year changes in a validated, claims-based frailty index (CFI; scores range 0-1, with higher scores indicating greater frailty). Compared to new DPP-4 inhibitor users, GLP-1 receptor agonist users had a mean CFI change of -0.007 (95% CI: -0.011 to -0.004) and those taking SGLT-2 inhibitors had a mean change of -0.005 (95% CI: -0.008 to -0.002), indicating slower progression indicates frailty. Sulfonylurea users showed no significant difference. Further analysis found that cardiovascular or other safety-related events accounted for only a small portion of the effect, suggesting that there is a potential direct benefit of these medications on frailty itself.

Important information about frailty

According to previous studies, approximately 10-15% of adults over the age of 65 experience frailty, with rates higher in those with type 2 diabetes. People with diabetes are particularly at risk due to chronic Inflammation, muscle loss, cardiovascular disease and the cumulative burden of managing a complex disease. Frailty is associated with falls, disability, hospitalization and a shortened lifespan. Because frailty is difficult to reverse once established, slowing the progression of frailty has emerged as an important goal in geriatric care, making the results of this study particularly important for older adults with diabetes.

"While SGLT-2 inhibitors and GLP-1 receptor agonists are primarily prescribed for glycemic control and cardiac protection, our results show that they may also help older adults with diabetes stay stronger and less vulnerable to health setbacks. Because frailty is common, serious, and difficult to reverse, this could significantly change the way clinicians think about drug selection for aging patients."

Chanmi Park, MD, MPH, lead author of the study, Assistant Scientist I, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife

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