ArticleDiabetologia2024
Safety and effectiveness of SGLT2 inhibitors in a UK population with type 2 diabetes and aged over 70 years: an instrumental variable approach.
Article in Diabetologia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interrelationship Between Baseline HbA1c, SGLT-2 Inhibitor Use and Risk of Diabetic Ketoacidosis in Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis.Diabetes, obesity & metabolism · 2026Pooled it
- Efficacy and safety of SGLT2 inhibitors in elderly patients with type 2 diabetes.Annals of medicine · 2026Article
- Management of type 2 diabetes, 2026. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).Diabetologia · 2026Article
- Trends in Second-Line Initiations and Treatment Outcomes Across Age and Frailty Groups in People With Type 2 Diabetes: UK Population-Based Study, 2019-2024.Diabetes, obesity & metabolism · 2026Article
- Differential effects of dapagliflozin and empagliflozin on skeletal muscle mass in older adults with type 2 diabetes.Endocrine · 2026Article
- Precision Prescribing of SGLT2 Inhibitors in Individuals With Type 2 Diabetes for Primary Prevention of Heart Failure: Model Development and Validation Study.Diabetes care · 2026Article
- Effectiveness of SGLT2 Inhibitors in Type 2 Diabetes: A Systematic Integrative Review of Reviews and Comparative Effectiveness Studies (2020-2025).Pharmacy (Basel, Switzerland) · 2026Review
- Validation of an algorithm for selection of SGLT2 and DPP4 inhibitor therapies in people with type 2 diabetes across major UK ethnicity groups: a retrospective cohort study.The Lancet regional health. Europe · 2026Article
- Diabetes and its complications: molecular mechanisms, prevention and treatment.Signal transduction and targeted therapy · 2026Review
- GLP-1RA precision medicine in people with type 2 diabetes: current insights and future prospects.The Journal of clinical investigation · 2026Review
- Fill Patterns of Glucose-Lowering Drugs with Cardiovascular and Kidney Benefits in the Rural and Urban United States, 2012-2021.Journal of general internal medicine · 2026Article
- Improving our understanding of the biology of aging: findings from the Age-It Research Program.The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- Comparative effectiveness of alternative second-line oral glucose-lowering therapies for type 2 diabetes: a precision medicine approach applied to routine data.Diabetologia · 2025Article
- Evaluating prediction of short-term tolerability of five type 2 diabetes drug classes using routine clinical features: UK population-based study.Diabetes, obesity & metabolism · 2025Article
- Instrumental Variable Methods to Target Hypothetical Estimands With Longitudinal Repeated Measures Data: Application to the STEP 1 Trial.Statistics in medicine · 2025Article
- Addressing methodological considerations in the assessment of the effect of SGLT2 inhibitors and GLP-1 receptor agonists on risk of diabetic eye complications.Diabetologia · 2025Article
- Benefit and Safety of Sodium-Glucose Co-Transporter 2 Inhibitors in Older Patients with Type 2 Diabetes Mellitus.Diabetes & metabolism journal · 2024Review
- Making causal inferences from transactional data: A narrative review of opportunities and challenges when implementing the target trial framework.The Journal of international medical research · 2024Review
- Sodium-glucose co-transporter 2 inhibitors use and the risks of genital and urinary tract infection: What should we know?Tzu chi medical journalReview
- Increasing Prescription of SGLT2 Inhibitors with Expanded Indications to the Elderly Population in Japan.Kidney diseases (Basel, Switzerland)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
aims/hypothesisOlder adults are under-represented in trials, meaning the benefits and risks of glucose-lowering agents in this age group are unclear. The aim of this study was to assess the safety and effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in people with type 2 diabetes aged over 70 years using causal analysis.
methodsHospital-linked UK primary care data (Clinical Practice Research Datalink, 2013-2020) were used to compare adverse events and effectiveness in individuals initiating SGLT2i compared with dipeptidyl peptidase-4 inhibitors (DPP4i). Analysis was age-stratified: <70 years (SGLT2i n=66,810, DPP4i n=76,172), ≥70 years (SGLT2i n=10,419, DPP4i n=33,434). Outcomes were assessed using the instrumental variable causal inference method and prescriber preference as the instrument.
resultsRisk of diabetic ketoacidosis was increased with SGLT2i in those aged ≥70 (incidence rate ratio compared with DPP4i: 3.82 [95% CI 1.12, 13.03]), but not in those aged <70 (1.12 [0.41, 3.04]). However, incidence rates with SGLT2i in those ≥70 was low (29.6 [29.5, 29.7]) per 10,000 person-years. SGLT2i were associated with similarly increased risk of genital infection in both age groups (incidence rate ratio in those <70: 2.27 [2.03, 2.53]; ≥70: 2.16 [1.77, 2.63]). There was no evidence of an increased risk of volume depletion, poor micturition control, urinary frequency, falls or amputation with SGLT2i in either age group. In those ≥70, HbA CONCLUSIONS/
interpretationCausal analysis suggests SGLT2i are effective in adults aged ≥70 years, but increase risk for genital infections and diabetic ketoacidosis. Our study extends RCT evidence to older adults with type 2 diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.