SGLT-2 inhibitors are a type of glucose-lowering medication for people with type 2 diabetes that have been shown to have impressive effects. They also help people with other diabetes-related health conditions, such as heart disease, heart failure, and kidney disease.
Type 2 diabetes is more prevalent in people older than 65 compared to younger populations (almost one in four people 65 and older have diabetes), and recent studies have provided evidence that SGLT-2 inhibitors may be a promising therapy for these people.
“The aging process is strongly associated with the development of type 2 diabetes,” Maria Lunati from the University of Milan. Elderly individuals also often have multiple comorbidities (or other medical conditions) and are at higher risk for cardiovascular (heart) and kidney complications.
Considering the increased risk for complications and the beneficial potential of SGLT-2 inhibitors, effects of these therapies have been studied in older people with type 2 diabetes. Overall, the results showed that “SGLT-2 inhibitors appear to be a valid therapeutic option in elderly populations,” Dr. Lunati said.
In one study, treatment with an SGLT-2 inhibitor provided a significant decline in glucose values and a 0.3 percentage point reduction in A1C after a one year follow-up. Additionally, eGFR values (a measure for how well your kidney is functioning) remained stable over time, highlighting the well-tolerated nature of the therapy.
Another study further explored the benefits of Steglatro, a common SGLT-2 inhibitor. This VERTIS-CV trial studied the effects of Steglatro in over 8,000 people with type 2 diabetes and cardiovascular disease (CVD). The trial found that treatment with ertugliflozin reduced participants’ A1C by an average of 0.5 percentage points, lowered their average weight by nearly five pounds, and reduced blood pressure compared to standard diabetes treatment. Ertugliflozin also improved kidney function (as measured by eGFR) and reduced the number of study participants with heart failure. You can learn more about the VERTIS-CV trial results here.
Dr. Richard Pratley, medical director at AdventHealth Diabetes Institute, took a more focused approach to the VERTIS-CV study analysis and presented on the effectiveness of ertugliflozin, specifically in elderly individuals. “Our objective in this analysis was to assess selected cardiovascular and kidney outcomes and the safety [of Steglatro] in older patients with type 2 diabetes and atherosclerotic cardiovascular disease in the VERTIS CV,” he said.
The results showed that “the effects of ertugliflozin on cardiovascular and kidney outcomes did not differ by treatment assignment between the subgroups of patients above 65 and below 65 years or in the subgroups of patients above 75 and below 75 years,” Dr. Pratley said.
Simply put, the results in the older population were consistent with the results from the overall original cohort from the VERTIS-CV study (regardless of age). This indicates that Steglatro can be assumed to be generally well tolerated in older populations patients with no specific safety concerns for this group.
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