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Is strict glycemic control meaningless for older adults?


 


Similarly, in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), the DPP-4 inhibitor did not increase severe hypoglycemia in the subgroup of participants aged 75 years and older.

And in several of the recent cardiovascular outcomes trials demonstrating cardiovascular benefit for type 2 diabetes agents, those benefits have been just as robust among older participants, he stressed.

These include the Researching Cardiovascular Events With a Weekly Incretin in Diabetes (REWIND) trial, in which those aged above and below 66 years experienced similar results with dulaglutide, a GLP-1 agonist.

And the landmark Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), which actually showed even greater protection against cardiovascular events among subjects aged 65 and older (hazard ratio, 0.86).

Also in the Dapagliflozin-Heart Failure (Dapa-HF) study, the SGLT-2 inhibitor reduced worsening of heart failure in patients with heart failure with reduced ejection fraction, regardless of age or presence of diabetes.

“I argue that older patients have rights to receive appropriate and effective treatment to prevent diabetes complications,” Dr. Suzuki concluded.

Dr. Munshi is a consultant for Sanofi and Lilly. Dr. Suzuki has received honoraria from MSD, Novo Nordisk, Novartis Pharma, Takeda, Mitsubishi Tanabe, and Eli Lilly Japan.

A version of this story originally appeared on Medscape.com.

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