The lancet. Healthy longevity

Starting SGLT2 inhibitors and GLP-1 receptor agonists in people with type 2 diabetes and heart disease, by frailty level in Denmark

Updated

Abstract

Of 103,790 people with type 2 diabetes and cardiovascular disease, frailty was associated with a significantly lower probability of initiating therapy with SGLT2 inhibitors or GLP-1 receptor agonists.

  • Frailty categorization included non-frail, moderately frail, and severely frail individuals, with 64.5%, 28.2%, and 7.4% of participants falling into these groups, respectively.
  • Moderately frail individuals had a hazard ratio of 0.91 for initiating therapy compared to non-frail individuals, while severely frail individuals had a hazard ratio of 0.75.
  • The association between frailty and lower initiation rates of these therapies remained significant after adjusting for various factors including age, sex, and comorbidities.
  • Median follow-up time was 4.5 years, with a median age of 71 years among participants.

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Funding

Competing interests

Declaration of interests MEM receives grants from the CARDIO-HGH Foundation, Herlev and Gentofte University Hospital, and the Danish Cardiovascular Academy. MS receives lecture fees from Novartis, Boehringer Ingelheim, AstraZeneca, and Novo Nordisk. ACF receives grants from Steno Diabetes Center Sjaelland, Region Sjælland Den Sundhedsvidenskabelige Forskningsfond, and Murermester Lauritz Peter Christensen og Hustru Kirsten Sigrid Christensens Fond. JHB participates on an advisory board for Bayer. JJ receives grants from The Danish Heart Foundation and the CARDIO-HGH Foundation; receives payment and honoraria for lectures, presentations, and manuscript writing from Boehringer Ingelheim; and participates on advisory boards for AstraZeneca and Boehringer Ingelheim. JES receives grants from Herlev-Gentofte Forskningsfond, Snedkermester Sophus Jacobs; Torben og Alice Frimodts Fond; Dagmar Marshalls Fond; and Eva og Henry Frænkels Mindefond. LK receives speaker honoraria from Novo Nordisk, AstraZeneca, Novartis, and Boehringer Ingelheim. MCP receives grants and contracts from Boehringer Ingelheim, Roche, SQ Innovation, AstraZeneca, Novartis, Novo Nordisk, and Pharmacosmos; receives consulting fees from Boehringer Ingelheim, Novartis, AstraZeneca, Novo Nordisk, AbbVie, Bayer, Takeda, Corvia, Cardiorentis, Pharmacosmos, Siemens, and Vifor; receives payment or honoraria for lectures, presentations, manuscript writing, or educational events from Boehringer Ingelheim, Novartis, AstraZeneca, Novo Nordisk, AbbVie, Bayer, Takeda, Corvia, Cardiorentis, Pharmacosmos, Siemens, and Vifor; participates on a data safety monitoring board and advisory board for Takeda and Taikoku; and is the Director of Global Clinical Trials Partners. NS receives grants and contracts from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics; receives consulting fees from Abbott Laboratories, Afimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Roche Diagnostics, and Sanofi; and receives fees for lectures or manuscript writing from Abbott Laboratories, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, and Novo Nordisk. JJVM receives payment or honoraria for lectures, presentations, speaker bureaus, or manuscript writing from Abbott, Alkem Metabolics, Eris Lifesciences, Hikma, Lupin, Sun Pharmaceuticals, Medscape, Herat.org, ProAdWise, Servier, and the Corpus. JJVM receives payment for participating on advisory boards for Cytokinetics, Amgen, AstraZeneca, Theracos, Ionis Pharmaceuticals, DalCor, Cardurion, Novartis, GlaxoSmithKline, Bayer, KBP Biosciences, Boehringer Ingelheim, and Bristol Myers Squibb. All other authors declare no competing interests.
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