Age May Influence Effectiveness of Diabetes Medications

The effectiveness of diabetes medications appears to be influenced by age, according to recent research. A study led by researchers from the University of Glasgow examined the relationship between sex, age, and the efficacy of popular diabetes treatments, including SGLT-2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors. Their findings were published in the journal 'JAMA.'

In total, the researchers analyzed data from 601 studies, of which 592 reported on HbA1c levels across 309,503 participants, while 23 studies involving 168,489 participants focused on major adverse cardiovascular events (MACE). Notably, the analysis found no significant impact of sex on the effectiveness of these medications. However, age appeared to play a crucial role in how well these treatments worked for individuals with type 2 diabetes.

The results indicated that the use of SGLT-2 inhibitors was associated with a lesser reduction in HbA1c levels as patients aged. This trend was consistent across mono-, dual-, and triple therapy regimens. Conversely, treatment with GLP-1 receptor agonists showed a greater reduction in HbA1c levels for older patients, specifically in mono- and dual therapy, while triple therapy did not exhibit the same benefit. Interestingly, DPP-4 inhibitors were linked to a modest improvement in HbA1c levels for older adults, particularly within dual therapy, but not in mono- or triple therapy.

Furthermore, the influence of age on MACE outcomes was also significant. Older participants benefited more from SGLT-2 therapy, with a greater relative risk reduction observed for every 30-year increase in age, as indicated by a hazard ratio of 0.76. In contrast, younger patients experienced more pronounced benefits from GLP-1 receptor agonists, as the relative reduction in MACE among older individuals was less significant, with a hazard ratio of 1.47.

These findings suggest that while SGLT-2 inhibitors may result in lower HbA1c reductions in older adults, they offer greater cardiovascular protection compared to younger patients. On the other hand, GLP-1 receptor agonists appear to be more cardioprotective for younger individuals. The researchers concluded that age should be a consideration when prescribing diabetes medications, as it can significantly impact both glycemic control and cardiovascular outcomes.