SGLT2-inhibithors in frail older people with type 2 diabetes

Abstract

Many studies have provided compelling evidence of efficacy and safety of SGLT2 inhibitors (Sglt2-i) both for glycemic control and for reducing risk of cardiovascular and renal outcomes in type 2 diabetic patients. An extensive use of these molecules in high-risk people – as elderly people are – would be theoretically desirable. However only on a real-world setting this class of drugs are underused in elderly patients because of physician’s concerns about efficacy and safety of SGLT2-i, in vulnerable and frail people. Our article aimed to evaluate current evidence about long-term efficacy and safety of SGLT-i in frail-older patients with type 2 diabetes. Current evidence suggest frailty should not be considered as limiting factor in the use of SGLT2 inhibitors which, on the other hand, could represent an opportunity to improve the quality of life (e.g. reduction of hospitalizations for SCC) in most frail patients. However, careful clinical evaluations should be recommended to minimize the risk of adverse effects. KEY WORDS frailty; older people; safety; SGLT2-i.