REAL WORLD SAFETY AND EFFICACY OF SGLT-2 INHIBITORS IN ELDERLY TYPE 2 DIABETIC PATIENTS

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We would like to evaluate the real world experience in safety and efficacy of adding SGLT-2 inhibitors to Elderly DM2 patients with an inadequate glycemic control. Elderly patients are frailer, have been diabetics for longer, have more diabetic complications, comorbidities and polypharmacy and therefore might be more susceptible to the effect of SGLT-2 inhibitors. We studied 67 elderly DM2 patients who had been treated with SGLT-2 inhibitors for more than 6 months in our Health Department during 2015. Safety data was collected on most frequent and harmful events in this frail group as recorded in the computerized Primary and Hospital Care Medical Records. Patients’ data: mean age: 67 years, 39% women, mean period diabetes: 12,5 years. 79% had hypertension, 81% had Hypercholesterolemia, 51% had a BMI > 30 and, 33% had a previous cardiovascular event. Antidiabetic treatment: 36% on insulin, 75% on Metformin, 45% on sulphonilurea (SU), 37% on DPP-IV inhibitors, 12% on pioglitazone and 13% on GLP-1 analogues. Mean treatment period was 8 months Results before and after SGLT-2 inhibitors treatment were: HbA1c. 8,48 (SD 1,1) vs 7,44 (SD 0.8) % (p < 0,01); (37% achieved HbA1c < 7%) Weight: 91,0 (SD 18) vs 88,8 (SD 17) kg (p< 0,01); Systolic BP: 134 (SD 9) vs 131 (SD 8) mmHg (P: 0,04). There were no statistical significant changes in e-GFR, lipid profile, hematocrit, diastolic BP and heart rate. No severe hypoglycemia, falls, diabetic ketoacidosis, or fungal infections were recorded during this period. Only 3 patients were treated for urinary tract infections. Two patients had thiazide treatment withdrawal during summer period because of symptomatic hypotension. No new cardiovascular events during treatment period. Hypoglycemia records were associated to insulin and SU treatment. SGLT-2 inhibitors are safe and effective in not well controlled elderly DM2 patients in a real world experience. Effect on systolic BP should be considered as antihypertensive treatment might need to be reviewed.

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