SLGT-2 inh have cardiovascular and renal protection effect. Elderly diabetic patients are more prone to cardiovascular events but are frailer with more comorbidities and more prone to SLG2-inh adverse effects. These patients are not represented in RCT as they not fulfil inclusion criteria.
Aim: Evaluate long term safety and efficacy of adding SGLT2 inhibitors to Elderly DM2 patients with uncontrolled glycemia in real life experience.
Method: We studied 72 Elderly DM2 patients treated with SGLT2 inhibitors for more than 5 years in our Health Department. Efficacy, Safety and Durability data was collected from our computerized Primary and Hospital Medical Records at baseline and after 5 years.
Results: Patients’ basal data: mean age: 71,6 years, 42% women, mean period diabetes: 12,5 years. Prevalence Hypertension 79%, Dyslipidemia 81% Obesity 51% and previous cardiovascular events 42%. Antidiabetic Treatment: Metformin (78%), SU (31%) Gliptines (37%) Pioglitazone (12%), GLP-1A (13%) and Insulin (36%). Results Before and After 5-year SGLT2 inh Treatment: HbA1c. 8,5 vs. 7,2% (p < 0,05); (38% maintained HbA1c < 7.5%) Weight: 90.9 vs. 86.7 kg (p< 0,05); Systolic BP: 133.2 vs. 128.6 mmHg (P< 0,05) Albumin-Creatinine ratio (ACR): 58,7 vs. 36,2 mg/g (p< 0,05) There were no statistical significant changes in e-GFR, microalbuminuria, lipid profile and hematocrit. No falls, volume depletion, severe hypoglycemia or ketoacidosis were recorded. 17% were treated for urinary-genital infections and half of them withdraw SLGT2i. 22% had a new non-fatal cardiovascular events and 6% heart failure hospitalization. There was a 17% mortality mainly due to neoplasic causes.
Discussion: 5-year SGLT2 inh. treatment in Elderly DM2 patients was safe and effective as in RCT. They had a significant maintained reduction in HbA1c, weight, systolic BP and ACR. Genito-urinary infection, although not frequent, was the main cause of withdraw.
C. Trescoli: None. P. Palasi: None. P. Platero: None. A. Trescoli-Garcia: None. B. Espinosa: None. M. Vercher: None.