Type 2 diabetes: SGLT2 inhibitors not tied to fracture risk in older adults, finds study

Boston, MA: A recent study in the JAMA Network Open has shown that the initiation of SGLT2 inhibitors does not appear to increase the risk of fracture in older adults with type 2 diabetes versus other diabetes agents. 

Older adults with type 2 diabetes (T2D) are known to be at a higher risk of death from cardiovascular disease compared to their peers without T2D. Sodium-glucose cotransporter–2 inhibitors (SGLT-2i) are oral diabetes medications that reduce the risk of end-stage kidney disease, atherosclerotic cardiovascular events, hospitalization for heart failure, and death among adults with T2D. However, results from previous studies have shown SGLT-2i to be associated with increased fracture risk. 

Based on the above background, Min Zhuo, Harvard Medical School, Boston, Massachusetts, and colleagues aimed to examine the association of incident fracture among older adults with T2D with initiating an SGLT-2i compared with initiating a dipeptidyl peptidase 4 inhibitor (DPP-4i) or a glucagon-like peptide 1 receptor agonist (GLP-1RA).

For this purpose, the researchers performed a population-based, new-user cohort study including older adults with T2D enrolled in Medicare fee-for-service from April 2013 to December 2017. New users of an SGLT-2i, DPP-4i, or GLP-1RA without a previous fracture were matched in a 1:1:1 ratio using 3-way propensity score matching.