Evidence map›Paper›PMID 38287703›Full record

SynthesisAge and ageing2024

Sodium-glucose cotransporter-2 inhibitors (SGLT2) in frail or older people with type 2 diabetes and heart failure: a systematic review and meta-analysis.

Rami Aldafas, Tomas Crabtree, Mohammed Alkharaiji, Yana Vinogradova, Iskandar Idris

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 3 pooled it
17.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Rami AldafasDivision of Graduate Entry Medicine and Health Sciences, University of Nottingham, Derby, UK.
Tomas CrabtreeDivision of Graduate Entry Medicine and Health Sciences, University of Nottingham, Derby, UK.ORCID 0000-0001-7886-8262
Mohammed AlkharaijiFaculty of Public Health, College of Health Science, The Saudi Electronic University, Riyadh, Saudi Arabia.
Yana VinogradovaDivision of Primary Care, University of Nottingham, Nottingham NG2 7RD, UK.
Iskandar IdrisDivision of Graduate Entry Medicine and Health Sciences, University of Nottingham, Derby, UK.
University of Nottingham · GBSaudi Electronic University · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSodium-glucose cotransporter-2 inhibitors (SGLT2Is) reduce cardio-metabolic and renal outcomes in patients with type 2 diabetes (T2D) but their efficacy and safety in older or frail individuals remains unclear.

methodsWe searched PubMed, Scopus, Web of Science, Cochrane CENTRA and Google Scholar and selected randomised controlled trials and observational studies comparing SGLT2Is versus placebo/other glucose-lowering agent for people with frailty or older individuals (>65 years) with T2D and heart failure (HF). Extracted data on the change in HbA1c % and safety outcomes were pooled in a random-effects meta-analysis model.

resultsWe included data from 20 studies (22 reports; N = 77,083 patients). SGLT2Is did not significantly reduce HbA1c level (mean difference -0.13, 95%CI: -0.41 to 0.14). SGLT2Is were associated with a significant reduction in the risk of all-cause mortality (risk ratio (RR) 0.81, 95%CI: -0.69 to 0.95), cardiac death (RR 0.80, 95%CI: -0.94 to 0.69) and hospitalisation for heart failure (HHF) (RR 0.69, 95%CI: 0.59-0.81). However, SGLT2Is did not demonstrate significant effect in reducing in the risk of macrovascular events (acute coronary syndrome or cerebral vascular occlusion), renal progression/composite renal endpoint, acute kidney injury, worsening HF, atrial fibrillation or diabetic ketoacidosis.

conclusionsIn older or frail patients with T2D and HF, SGLT2Is are consistently linked with a decrease in total mortality and the overall burden of cardiovascular (CV) events, including HHF events and cardiac death, but not protective for macrovascular death or renal events. Adverse events were more difficult to quantify but the risk of diabetic ketoacidosis or acute kidney injury was not significantly increase.

Indexed as

Diabetes Mellitus, Type 2Diabetic KetoacidosisHeart FailureSodium-Glucose Transporter 2 InhibitorsAgedDeathFrail ElderlyGlucoseGlycated HemoglobinHumansSodiumSodium-Glucose Transporter 2GlucoseGlycated HemoglobinSodiumSodium-Glucose Transporter 2Sodium-Glucose Transporter 2 Inhibitorsfrailheart failureolderolder peoplesodium-glucose cotransporter 2 inhibitorssystematic reviewtype 2 diabetes

Identifiers

PMID38287703
PMCPMC10825241
OpenAlexW4391358399

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.