Efficacy and Safety of SGLT2 Inhibitors in Elderly (≥75 Years) With Type 2 Diabetes: A Real-World Study
https://doi.org/10.15605/jafes.041.S1
- Author:
Siew Wai Shuit
1
;
Shamharini Nagaratnam
1
;
Fei Bing Yong
1
;
Norisha Nandini Passkaren
1
;
Keen Tien Boey
1
;
Nur Syahirah Asarapoo
1
;
Sathya Rajagopal
1
;
Vikganesa Mahalingam
1
;
Zanariah Hussein
1
Author Information
1. Endocrine Unit, Medical Department, Hospital Putrajaya
- Publication Type:Journal Article
- MeSH:
Aged;
Diabetes Mellitus, Type 2;
Sodium-Glucose Transporter 2 Inhibitors
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):36-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Sodium-glucose-linked-transporter inhibitors (SGLT2-i)
have demonstrated cardiovascular and renal benefits in
type 2 diabetes mellitus (T2DM), but patients aged ≥75
years remain underrepresented in major trials, creating
uncertainty regarding their risk–benefit profile. Real-world
data show mixed safety signals. In Malaysia, local evidence
is limited despite a growing elderly diabetic population.
This study evaluates the glycemic efficacy and safety of
SGLT2-i in advanced elderly patients in a real-world public
hospital setting.
Methodology:We conducted a retrospective observational cohort study
of patients aged ≥75 years with T2DM initiated on SGLT2-i
in Hospital Putrajaya (2020–2024). Electronic records were
reviewed for demographics, comorbidities, medications,
and biochemical parameters. Outcomes at 6–12 months
assessed glycemic control and safety. Adverse events
and discontinuation rates were recorded. Patients with
incomplete data, type 1 diabetes, active malignancy, or
severe renal impairment were excluded.
Results:A total of 104 patients (mean age 78.2 years; 54% female)
were included with a high proportion (76.9%) classified as at
high cardiovascular risk due to established macrovascular
disease (57.7%) or nephropathy (53.8%). Indications for
SGLT2-i initiation were glycemic control alone (69.2%) and
together with cardiorenal protection (58.7%). Glycemic
control remained stable (hemoglobin A1c: 7.66–7.45%; p =
0.076), with preserved renal function (estimated glomerular
filtration rate: 58.65–58.11 mL/min/1.73 m²; p = 0.575).
Overall safety was favorable, with 90.4% experiencing no
adverse events. Minor adverse events included urinary
tract infections (2.9%) and polyuria (1.9%). ASCVD-related
hospitalizations occurred in 4.8% of patients, with a low
discontinuation rate (7.7%). A statistically significant
weight reduction was observed (baseline 66.67 kg, −1.01
kg; p = 0.005) but was not clinically significant. Proteinuria
improvement was noted in 15.7% of patients.
Conclusion:SGLT2-i are safe and well-tolerated in elderly T2DM
patients (≥75 years), with stable glycemic control, preserved
renal function, and minimal adverse events, supporting
their use in very elderly Asian populations.
- Full text:2026072817132085586EP_A032.pdf
