Trends in Second‐Line Initiations and Treatment Outcomes Across Age and Frailty Groups in People With Type 2 Diabetes: UK Population‐Based Study, 2019–2024
Authors' conclusion
Use of SGLT2-inhibitors rapidly increased in the UK over 2019-2024, with a 10-fold increase among older adults with frailty. Over the same period, there were small population-level benefits for HbA1c and weight, with no evidence of changes in complication risk.
Study context
- Population
- UK adults with T2D initiating second-line therapy, 2019–2024 (Clinical Practice Research Datalink)
- Participants
- 117,046 adults
- Exposure
- Trends in second-line treatment initiations and outcomes across age-and-frailty groups
- Age ≤ 70 yearsn = 84,589
- Non-frail > 70 yearsn = 18,933
- Frail > 70 yearsn = 13,524
- Outcome
- SGLT2i share of second-line initiations
- Follow-up
- 2019 to 2024
Main finding
As reported in the abstract
SGLT2i use, overall second-line initiations, 2019 vs 2024
26% vs 63%
SGLT2i use, frail adults > 70 (greatest increase), 2019 vs 2024
6% vs 60%
Observational data: associations, not effects.
Further findings
Mean 12-month HbA1c response, adults ≤ 70 · 2019 to 2023
Mmol/mol
- 2019
- −11.3 (95% CI −11.6 to −11.0)
- 2023
- −12.9 (95% CI −13.2 to −12.6)
Mean weight loss, adults ≤ 70 · 2019 to 2023
kg
- 2019
- −1.7 (95% CI −1.8 to −1.5)
- 2023
- −2.8 (95% CI −2.9 to −2.6)
Similar time trends across subgroups
- Similar time trends in treatment outcomes across all age-and-frailty based subgroups
Safety
Incidence of short-term severe diabetes-related complications · 2019 vs 2022
- 2019
- 9.9 per 1000 person-years (95% CI 8.1 to 11.7)
- 2022
- 8.6 (95% CI 6.9 to 10.3)
- Remained similar
Original publication
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