The Use of SGLT2 Inhibitors in Elderly Patients with Type 2 Diabetes Mellitus

Aim: Sodium glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic agents that act on the proximal renal tubules to lower blood glucose levels by inhibiting glucose reabsorption and promoting urinary glucose excretion. This study assessed the long-term use of SGLT2 inhibitors in elderly patients. Methods: A total of 117 elderly patients with type 2 diabetes who were administered SGLT2 inhibitors were enrolled from April 2014 to March 2016. Results: The mean age of patients was 73.7 years. During the follow-up period (mean: 289.3 days), there was no event associated with oral administration of SGLT2 inhibitors. These drugs significantly lowered fasting blood glucose and glycosylated hemoglobin levels at 6 months, and did not affect the creatinine (Cre) level, BUN/Cre ratio, or estimated glomerular filtration rate during treatment. Although the treatment significantly increased hematocrit levels, it did not affect the ultrasonographically determined diameter of the inferior vena cava, and no signs of intravascular collapse were observed. Changes in brain natriuretic peptide (BNP) levels during the follow-up period were assessed in 78 patients with a BNP level exceeding the normal upper limit before treatment with SGLT2 inhibitors. The BNP levels significantly decreased after 6 months of treatment. Conclusions: In elderly Japanese patients with diabetes, treatment with SGLT2 inhibitors for 6 months exerted a favorable hypoglycemic effect, while no sign of dehydration was observed.