PMID- 30758423
OWN - NLM
STAT- MEDLINE
DCOM- 20190312
LR  - 20190312
IS  - 1806-9282 (Electronic)
IS  - 0104-4230 (Linking)
VI  - 65
IP  - 1
DP  - 2019 Jan
TI  - Inhibition of the sodium-glucose co-transporter 2 in the elderly: clinical and 
      mechanistic insights into safety and efficacy.
PG  - 70-86
LID - S0104-42302019000100070 [pii]
LID - 10.1590/1806-9282.65.1.70 [doi]
AB  - The prevalence of type 2 diabetes mellitus (T2DM) in the elderly grew sharply 
      over the last decade. Reduced insulin sensitivity and secretory capacity, weight 
      gain, sarcopenia, and elevated adiposity are all common metabolic and body 
      changes in the aging population that favor an increased risk of hypoglycemia, 
      frailty syndrome, falls, and cognitive dysfunction. First line antidiabetic 
      therapy is frequently not safe in older individuals because of its high risk of 
      hypoglycemia and prevalent co-morbid diseases, such as chronic kidney disease, 
      osteoporosis, cardiovascular disease, and obesity. Sodium-glucose cotransporter 2 
      inhibitor (SGLT2i) is a new class of antidiabetic therapy that inhibits glucose 
      and sodium reabsorption on renal proximal convoluted tubule. Its effect is well 
      demonstrated in various clinical scenarios in the younger population. This review 
      and metanalysis describe particularities of the SGLT2i on the elderly, with 
      mechanistic insights of the potential benefit and remaining challenges about the 
      use of these drugs in this important age group. Further, we will present a 
      meta-analysis of the main effects of SGLT2i reported in post-hoc studies in which 
      the median age of the subgroups analyzed was over 60 years. Despite the absence 
      of specific clinical trials for this population, our findings suggest that SGLT2i 
      therapy on older individuals is effective to lower glucose and maintain its 
      effect on systolic blood pressure and body weight.
FAU - Cintra, Riobaldo
AU  - Cintra R
AUID- ORCID: 0000-0001-6143-680X
AD  - Laboratory of Atherosclerosis and Vascular Biology, Unicamp, Campinas, SP, 
      Brasil.
FAU - Moura, Filipe A
AU  - Moura FA
AUID- ORCID: 0000-0001-8017-1675
AD  - Laboratory of Atherosclerosis and Vascular Biology, Unicamp, Campinas, SP, 
      Brasil.
FAU - Carvalho, Luis Sergio F de
AU  - Carvalho LSF
AUID- ORCID: 0000-0001-6465-356X
AD  - Laboratory of Atherosclerosis and Vascular Biology, Unicamp, Campinas, SP, 
      Brasil.
AD  - Cardiology Division, State University of Campinas (Unicamp), Campinas, SP, 
      Brasil.
FAU - Barreto, Joaquim
AU  - Barreto J
AUID- ORCID: 0000-0003-1914-316X
AD  - Laboratory of Atherosclerosis and Vascular Biology, Unicamp, Campinas, SP, 
      Brasil.
FAU - Tambascia, Marcos
AU  - Tambascia M
AUID- ORCID: 0000-0002-9158-6902
AD  - Endocrinology Division, State University of Campinas (Unicamp), Campinas, SP, 
      Brasil.
FAU - Pecoits-Filho, Roberto
AU  - Pecoits-Filho R
AUID- ORCID: 0000-0002-0255-6710
AD  - Pontificia Universidade Catolica do Parana, Curitiba, PR, Brasil.
FAU - Sposito, Andrei C
AU  - Sposito AC
AUID- ORCID: 0000-0001-7127-2052
AD  - Laboratory of Atherosclerosis and Vascular Biology, Unicamp, Campinas, SP, 
      Brasil.
AD  - Cardiology Division, State University of Campinas (Unicamp), Campinas, SP, 
      Brasil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - Brazil
TA  - Rev Assoc Med Bras (1992)
JT  - Revista da Associacao Medica Brasileira (1992)
JID - 9308586
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiovascular Diseases/drug therapy/metabolism
MH  - Diabetes Mellitus, Type 2/*drug therapy/metabolism
MH  - Frail Elderly
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/metabolism
MH  - Middle Aged
MH  - Risk Factors
MH  - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use
MH  - Treatment Outcome
EDAT- 2019/02/14 06:00
MHDA- 2019/03/13 06:00
CRDT- 2019/02/14 06:00
PHST- 2018/10/12 00:00 [received]
PHST- 2018/10/26 00:00 [accepted]
PHST- 2019/02/14 06:00 [entrez]
PHST- 2019/02/14 06:00 [pubmed]
PHST- 2019/03/13 06:00 [medline]
AID - S0104-42302019000100070 [pii]
AID - 10.1590/1806-9282.65.1.70 [doi]
PST - ppublish
SO  - Rev Assoc Med Bras (1992). 2019 Jan;65(1):70-86. doi: 10.1590/1806-9282.65.1.70.