A recent study published in Diabetes Care has found that older adults with type 2 diabetes who begin treatment with sodium–glucose cotransporter-2 (SGLT-2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists experience a slower progression of frailty over one year compared to those starting other diabetes medications. The research suggests these drugs may help older adults maintain strength, mobility, and independence, beyond their established benefits for blood sugar and heart health.
The study tracked older adults who had just started various diabetes medications and followed them for a year. It found that individuals taking SGLT-2 inhibitors—such as empagliflozin (Jardiance) and dapagliflozin (Farxiga)—or GLP-1 drugs—such as semaglutide (Ozempic) and liraglutide (Victoza)—were less likely to develop signs of frailty like weakness, slow movement, or fatigue than those on other diabetes treatments. Researchers noted that the observed benefit could not be fully explained by cardiovascular improvements alone, indicating a possible direct protective effect against frailty.
The analysis used a national 7% sample of U.S. Medicare claims to monitor changes in a validated claims-based frailty index over one year. Compared to new users of DPP-4 inhibitors, those starting GLP-1 receptor agonists showed a mean change in the index of –0.007 (95% CI: –0.011 to –0.004), while those on SGLT-2 inhibitors saw a mean change of –0.005 (95% CI: –0.008 to –0.002), both reflecting slower frailty progression. No significant difference was seen among users of sulfonylureas.
Previous studies have shown that approximately 10–15% of adults over age 65 are affected by frailty, with higher rates among people with type 2 diabetes due to factors such as chronic inflammation, muscle loss, and cardiovascular disease. Frailty increases risks for falls, disability, hospitalization, and shorter lifespan; once established it is difficult to reverse, making prevention an important focus in geriatric care.
"While SGLT-2 inhibitors and GLP-1 receptor agonists are primarily prescribed for blood sugar control and heart protection, our findings show they may also help older adults with diabetes stay stronger and less vulnerable to health setbacks," said Chanmi Park, MD, MPH, Assistant Scientist I at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife. "Because frailty is common, serious, and hard to reverse, this could meaningfully change how clinicians think about medication choices for aging patients."
