Vnitr Lek 2024, 70(7):430-437 | DOI: 10.36290/vnl.2024.085

The benefits and risks of new antidiabetic drugs for the treatment of geriatric patients with diabetes

Darina Matvejeva1, Martina Nováková1, 2, Pavlína Piťhová1, Milan Kvapil1
1 Geriatrická interní klinika 2. LF UK a FN Motol, Praha
2 Katedra dlouhověkosti (Longevity Studies) Fakulty humanitních studií UK, Praha

Life expectancy is increasing in patients with diabetes. The prevalence of diabetes increases with age. New classes of antidiabetics (gliflozins, incretin therapy, new insulin analogues) are safer, have at least comparable efficacy to conventional treatment, and also bring a positive impact on the risk of late complications of diabetes. The use of their potential for the treatment of elderly people with diabetes is particularly beneficial in terms of safety and prevention of complications.

Keywords: diabetes mellitus in older, safety of therapy, DPP4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors.

Accepted: October 24, 2024; Published: November 14, 2024  Show citation

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Matvejeva D, Nováková M, Piťhová P, Kvapil M. The benefits and risks of new antidiabetic drugs for the treatment of geriatric patients with diabetes. Vnitr Lek. 2024;70(7):430-437. doi: 10.36290/vnl.2024.085.
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    References

    1. https://www.uzis.cz/index.php?pg=registry-sber-dat--narodni-registr-hrazenych-zdravotnich-sluzeb (20. 8. 2024).
    2. Nováková, M, et al. Aktuální výsledky z diabetologického registru potvrzují "epidemické" rozšíření diabetu mezi seniory: otázky a odpovědi. Svět praktické medicíny. 2022;3(4):1-4
    3. Richter B, Bandeira-Echtler E, Bergerhoff K, et al. Pioglitazone for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2006 Oct 18;2006(4):CD006060. Go to original source...
    4. Karásek D. Pioglitazone. Vnitr Lek. 2020 Spring;66(2):121-125. Go to original source...
    5. Davies MJ, Aroda VR, Collins BS, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022 Nov 1;45(11):2753-2786. Go to original source... Go to PubMed...
    6. Mishriky BM, Cummings DM, Tanenberg RJ. The efficacy and safety of DPP4 inhibitors compared to sulfonylureas as add-on therapy to metformin in patients with Type 2 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2015 Aug;109(2):378-88. Go to original source... Go to PubMed...
    7. Deacon CF. Dipeptidyl peptidase 4 inhibitors in the treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2020 Nov;16(11):642-653. Go to original source... Go to PubMed...
    8. Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metab. 2021 Apr;46:101102. Go to original source... Go to PubMed...
    9. Yao H, Zhang A, Li D, et al. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. BMJ. 2024 Jan 29;384:e076410. Go to original source... Go to PubMed...
    10. Mikulecká V, Kvapil, M. Mysleli jsme to dobře, a málem to dopadlo trochu jinak. Běžná příčina manifestace syndromu "frailty" s dobrým koncem. Kasuistiky v diabetologii. 2022;20(4):20-23.
    11. Eng C, Kramer CK, Zinman B, Retnakaran R. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet. 2014 Dec 20;384(9961):2228-34. Go to original source... Go to PubMed...
    12. Forzano I, Varzideh F, Avvisato R, et al. Tirzepatide: A Systematic Update. Int J Mol Sci. 2022 Nov 23;23(23):14631. Go to original source... Go to PubMed...
    13. Wright EM. SGLT2 Inhibitors: Physiology and Pharmacology. Kidney360. 2021 Sep 17;2(12):2027-2037. Go to original source... Go to PubMed...
    14. Marilly E, Cottin J, Cabrera N, et al. SGLT2 inhibitors in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials balancing their risks and benefits. Diabetologia. 2022 Dec;65(12):2000-2010. Go to original source... Go to PubMed...
    15. Lingvay I, Handelsman Y, Linjawi S, et al. Efficacy and safety of ideglira in older patients with type 2 diabetes. Endocr Pract. 2019 Feb;25(2):144-155. Go to original source... Go to PubMed...
    16. Gough SC, Bode BW, Woo VC, et al. One-year efficacy and safety of a fixed combination of insulin degludec and liraglutide in patients with type 2 diabetes: results of a 26-week extension to a 26-week main trial. Diabetes Obes Metab. 2015 Oct;17(10):965-73. Go to original source... Go to PubMed...
    17. Kvapil M, Benešová K, Jarkovský J, Dušek L. Nejnovější výsledky analýz diabetologického registru. Výhledy a výzvy diabetologie. 2022;7(4):169-170.
    18. Palmer SC, Mavridis D, Nicolucci A, et al. Comparison of Clinical Outcomes and Adverse Events Associated With Glucose-Lowering Drugs in Patients With Type 2 Diabetes: A Meta-analysis. JAMA. 2016 Jul19;316(3):313-24. Go to original source... Go to PubMed...
    19. Giugliano D, Longo M, Maiorino MI, et al. Efficacy of SGLT-2 inhibitors in older adults with diabetes: Systematic review with meta-analysis of cardiovascular outcome trials. Diabetes Res Clin Pract. 2020 Apr;162:108114. Go to original source... Go to PubMed...
    20. Sinha B, Ghosal S. Meta-analyses of the effects of DPP-4 inhibitors, SGLT2 inhibitors and GLP1 receptor analogues on cardiovascular death, myocardial infarction, stroke and hospitalization for heart failure. Diabetes Res Clin Pract. 2019 Apr;150:8-16. Go to original source... Go to PubMed...
    21. Mannucci E, Nreu B, Montereggi C, et al. SID-AMD joint panel for Italian Guidelines on Treatment of Type 2 Diabetes. Cardiovascular events and all-cause mortality in patients with type 2 diabetes treated with dipeptidyl peptidase-4 inhibitors: An extensive meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2021 Sep 22;31(10):2745-2755. Go to original source... Go to PubMed...
    22. Bethel MA, Engel SS, Green JB, et al. TECOS Study Group. Assessing the Safety of Sitagliptin in Older Participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Diabetes Care. 2017 Apr;40(4):494-501. Go to original source... Go to PubMed...
    23. Espeland MA, Pratley RE, Rosenstock J, et al. Cardiovascular outcomes and safety with linagliptin, a dipeptidyl peptidase-4 inhibitor, compared with the sulphonylurea glimepiride in older people with type 2 diabetes: A subgroup analysis of the randomized CAROLINA trial. Diabetes Obes Metab. 2021 Feb;23(2):569-580. Go to original source... Go to PubMed...
    24. Cooper ME, Rosenstock J, Kadowaki T, et al. CARMELINA investigators. Cardiovascular and kidney outcomes of linagliptin treatment in older people with type 2 diabetes and established cardiovascular disease and/or kidney disease: A prespecified subgroup analysis of the randomized, placebo-controlled CARMELINA® trial. Diabetes Obes Metab. 2020 Jul;22(7):1062-1073. Go to original source... Go to PubMed...
    25. Leiter LA, Teoh H, Braunwald E, et al. SAVOR-TIMI 53 Steering Committee and Investigators. Efficacy and safety of saxagliptin in older participants in the SAVOR-TIMI 53 trial. Diabetes Care. 2015 Jun;38(6):1145-53. Go to original source... Go to PubMed...
    26. White WB, Cannon CP, Heller SR, et al. EXAMINE Investigators. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med. 2013 Oct 3;369(14):1327-35. Go to original source... Go to PubMed...
    27. Bilal A, Yi F, Gonzalez GR, et al. Effects of newer anti-hyperglycemic agents on cardiovascular outcomes in older adults: Systematic review and meta-analysis. J Diabetes Complications. 2024 Aug;38(8):108783. Go to original source... Go to PubMed...
    28. Ledesma G, Umpierrez GE, Morley JE, et al. Efficacy and safety of linagliptin to improve glucose control in older people with type 2 diabetes on stable insulin therapy: A randomized trial. Diabetes Obes Metab. 2019 Nov;21(11):2465-2473. Go to original source... Go to PubMed...
    29. Doucet J, Chacra A, Maheux P, et al. Efficacy and safety of saxagliptin in older patients with type 2 diabetes mellitus. Curr Med Res Opin. 2011 Apr;27(4):863-9. Go to original source... Go to PubMed...
    30. Karyekar CS, Ravichandran S, Allen E, et al. Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus. Clin Interv Aging. 2013;8:419-30. Go to original source... Go to PubMed...
    31. Iqbal N, Allen E, Öhman P. Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥ 65 years) with type 2 diabetes. Clin Interv Aging. 2014 Sep 4;9:1479-87. Go to original source... Go to PubMed...
    32. Pratley RE, Rosenstock J, Pi-Sunyer FX, Banerji MA, Schweizer A, Couturier A, Dejager S. Management of type 2 diabetes in treatment-naive elderly patients: benefits and risks of vildagliptin monotherapy. Diabetes Care. 2007 Dec;30(12):3017-22. Go to original source... Go to PubMed...
    33. Round EM, Engel SS, Golm GT, et al. Safety of sitagliptin in elderly patients with type 2 diabetes: a pooled analysis of 25 clinical studies. Drugs Aging. 2014 Mar;31(3):203-14. Go to original source... Go to PubMed...
    34. Barnett AH, Huisman H, Jones R, et al. Linagliptin for patients aged 70 years or older with type 2 diabetes inadequately controlled with common antidiabetes treatments: a randomised, double-blind, placebo-controlled trial. Lancet. 2013 Oct 26;382(9902):1413-23. Go to original source... Go to PubMed...
    35. Rosenstock J, Wilson C, Fleck P. Alogliptin versus glipizide monotherapy in elderly type 2 diabetes mellitus patients with mild hyperglycaemia: a prospective, double-blind, randomized, 1-year study. Diabetes Obes Metab. 2013 Oct;15(10):906-14. Go to original source... Go to PubMed...
    36. Nagao M, Sasaki J, Sugihara H, et al. STREAM Study Investigators. Efficacy and safety of sitagliptin treatment in older adults with moderately controlled type 2 diabetes: the STREAM study. Sci Rep. 2023 Jan 4;13(1):134. Go to original source... Go to PubMed...
    37. Wang Y, Shao X, Liu Z. Efficacy and safety of sodium-glucose co-transporter 2 inhibitors in the elderly versus non-elderly patients with type 2 diabetes mellitus: a meta-analysis. Endocr J. 2022 Jun 28;69(6):669-679. Go to original source... Go to PubMed...
    38. Pratley R, Dagogo-Jack S, Charbonnel B, et al. Efficacy and safety of ertugliflozin in older patients with type 2 diabetes: A pooled analysis of phase III studies. Diabetes Obes Metab. 2020 Dec;22(12):2276-2286 Go to original source... Go to PubMed...
    39. Bode B, Stenlöf K, Sullivan D, et al. Efficacy and safety of canagliflozin treatment in older subjects with type 2 diabetes mellitus: a randomized trial. Hosp Pract (1995). 2013 Apr;41(2):72-84. Go to original source... Go to PubMed...
    40. Sinclair AJ, Bode B, Harris S, et al. Efficacy and Safety of Canagliflozin in Individuals Aged 75 and Older with Type 2 Diabetes Mellitus: A Pooled Analysis. J Am Geriatr Soc. 2016 Mar;64(3):543-52. Go to original source... Go to PubMed...
    41. Aldafas R, Crabtree T, Alkharaiji M, et al. Sodium-glucose cotransporter-2 inhibitors (SGLT2) in frail or older people with type 2 diabetes and heart failure: a systematic review and meta-analysis. Age Ageing. 2024 Jan 2;53(1):afad254. Go to original source... Go to PubMed...
    42. Pasqualotto E, Rodrigues FR, E Silva Ribeiro GB, et al. The effect of sodium-glucose transporter 2 inhibitors on stroke in patients with type 2 diabetes: A meta-analysis. J Stroke Cerebrovasc Dis. 2024 Aug;33(8):107730. Go to original source... Go to PubMed...
    43. Pan SY, Su EL, Huang CJ, et al. Evaluation of glucose-lowering medications in older people: a comprehensive systematic review and network meta-analysis of randomized controlled trials. Age Ageing. 2024 Aug 6;53(8):afae175. Go to original source... Go to PubMed...
    44. Kvapil M, Břízová L, Nováková M. Léčba diabetu u starších pacientů. Farmakoter Revue 2023;8(1):1-5.
    45. Kvapil M, Nováková M. Antidiabetika v ordinaci internisty. Acta medicinae. 2022;14:in press.
    46. Nováková M, Kvapil M. Kardiovaskulární bezpečnost antidiabetik u seniorů. Svět prakt. medicíny. 2022;4:34-35.

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