Sodium–Glucose Cotransporter 2 Inhibitors, Glucagon-Like Peptide 1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes
Issued Date
2026-01-01
Resource Type
ISSN
01495992
eISSN
19355548
Scopus ID
2-s2.0-105025413414
Pubmed ID
41232081
Journal Title
Diabetes Care
Volume
49
Issue
1
Start Page
147
End Page
151
Rights Holder(s)
SCOPUS
Bibliographic Citation
Diabetes Care Vol.49 No.1 (2026) , 147-151
Suggested Citation
Park C.M., Thanapluetiwong S., Chen X., Oh G., Ko D., Kim D.H. Sodium–Glucose Cotransporter 2 Inhibitors, Glucagon-Like Peptide 1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes. Diabetes Care Vol.49 No.1 (2026) , 147-151. 151. doi:10.2337/dc25-1031 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114579
Title
Sodium–Glucose Cotransporter 2 Inhibitors, Glucagon-Like Peptide 1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVE Older adults with type 2 diabetes are at high risk for frailty. The effects of glucagon-like peptide 1 receptor agonists (GLP-1RAs) and sodium–glucose cotransporter 2 inhibitors (SGLT-2is) on frailty remain uncertain. RESEARCH DESIGN AND METHODS Using a 7% random sample of Medicare data, we compared new users of dipeptidyl peptidase 4 inhibitors (DPP-4is), GLP-1RAs, SGLT-2is, and sulfonylureas on 1-year frailty progression, measured by a claims-based frailty index (CFI) (range: 0–1; higher scores indicate greater frailty). Mediation analyses assessed whether cardiovascular or safety events explained differences in frailty progression. RESULTS Compared with DPP-4i users, the mean CFI change (95% CI) was significantly lower for GLP-1RA (−0.007 [−0.011, −0.004]) and SGLT-2i (−0.005 [−0.008, −0.002]) users; no difference was found for sulfonylurea users. These associations were minimally mediated by cardiovascular or safety events. CONCLUSIONS GLP-1RAs and SGLT-2is may slow frailty progression through mechanisms independent of cardiovascular benefits. Future trials should confirm these preliminary findings.