Diabetes drug class not clearly linked to added harm in adults 75-plus
A Canadian cohort compared 4,997 older adults starting one diabetes drug class with 1,289 starting another, but some harm estimates remained imprecise.
4,997 participants
Limit: Estimates for diabetic ketoacidosis, falls, and fractures allowed both benefit and harm
Edited by Boris Djordjevic · AgingResearch.News
Researchers used administrative health records for an observational cohort study of adults aged 75 and older with type 2 diabetes in British Columbia, Canada. They compared 4,997 people starting sodium-glucose cotransporter 2 inhibitors (median age 79; 37% women) with 1,289 starting dipeptidyl peptidase 4 inhibitors (median age 82; 50% women), both diabetes drug classes. Participants started the drugs during 2021–2023.
Starting the first class was linked to lower risks of sudden kidney injury and hospitalization for any cause. Hazard ratios, measures of relative risk over time, were 0.76 and 0.87, respectively. Researchers found no difference in infections. They also observed no differences in falls, fractures or diabetic ketoacidosis, a dangerous buildup of acids in the blood. For these last three outcomes, the ranges of likely effects included both benefit and harm.
Why it matters
For adults aged 75 and older with type 2 diabetes, the findings may support considering sodium-glucose cotransporter 2 inhibitors as a treatment option.
Caveats
This observational study cannot establish cause and effect, and imprecise estimates for some outcomes leave uncertainty about harms. The findings do not extend to younger adults or people without type 2 diabetes.
The paper
University of Southern Denmark; University of British Columbia
Diabetes Care, Oct 27, 2026
