A recent study reveals that older adults with type 2 diabetes may experience slower progression of frailty when treated with specific diabetes medications. Patients starting treatment with sodium–glucose cotransporter-2 (SGLT-2) inhibitors, such as empagliflozin (Jardiance) and dapagliflozin (Farxiga), or glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide (Ozempic) and liraglutide (Victoza), showed significant benefits over those beginning other diabetes treatments.
The study, titled “Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Frailty Progression in Older Adults With Type 2 Diabetes,” was published in the journal Diabetes Care in March 2025. Researchers analyzed data from a national sample of U.S. Medicare claims, focusing on older adults newly prescribed diabetes medications.
Over the course of one year, participants taking SGLT-2 inhibitors or GLP-1 receptor agonists exhibited a slower increase in frailty, evidenced by a validated claims-based frailty index. Those starting treatment with GLP-1 receptor agonists experienced a mean change of –0.007 (95% CI: –0.011 to –0.004), while users of SGLT-2 inhibitors saw a change of –0.005 (95% CI: –0.008 to –0.002). In contrast, those using DPP-4 inhibitors showed no significant change in frailty progression.
The findings suggest these diabetes medications may directly contribute to maintaining strength and mobility in aging patients. Notably, the researchers observed that cardiovascular events accounted for only a small portion of the benefits, indicating that these treatments may offer additional protective effects against frailty itself.
Frailty is a significant concern for older adults, particularly those with diabetes. According to earlier research, approximately 10% to 15% of individuals over the age of 65 experience frailty, with even higher rates among those managing type 2 diabetes. Chronic inflammation, muscle loss, and cardiovascular disease contribute to this vulnerability, leading to increased risks of falls, disability, and hospitalization. Given that frailty is difficult to reverse, slowing its progression is a critical objective in geriatric care.
Lead author of the study, Chanmi Park, MD, MPH, an Assistant Scientist I at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, emphasized the implications of these findings. “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.”
The research underscores the need for healthcare professionals to consider the broader benefits of diabetes medications when developing treatment plans for aging patients. As medical understanding of frailty evolves, these insights may play a pivotal role in enhancing the quality of life for older individuals dealing with diabetes.
The study’s results hold promise for transforming how clinicians approach medication choices for older adults, potentially leading to improved health outcomes and greater independence for this vulnerable population.
