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Empagliflozin in the elderly.

Gilles Berrut1, Anne Sophie Boureau2, Jean Noel Trochu3

  • 1Pôle hospitalo-universitaire de gérontologie clinique, CHU de Nantes, France, Université de Nantes, Faculté de médecine, Nantes, France.

Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement
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PubMed
Summary
This summary is machine-generated.

Gliflozins, a new drug class, lower blood glucose and aid weight loss by inhibiting kidney glucose reabsorption. Empagliflozin also reduces mortality and offers kidney protection, making gliflozins valuable for managing chronic diseases.

Keywords:
chronic kidney diseasediabetes mellituselderlygliflozinsheart failure

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Gliflozins represent a novel therapeutic class targeting glucose and sodium reabsorption.
  • Their mechanism involves inhibiting the renal proximal tubule co-transporter for glucose and sodium.
  • This action reduces blood glucose levels, leading to glycosuria and subsequent weight loss.

Purpose of the Study:

  • To elucidate the multifaceted benefits of gliflozins, including their impact on glycemic control, weight, blood pressure, and cardiovascular and renal health.
  • To highlight the specific advantages of empagliflozin, such as reduced mortality and nephroprotection.
  • To underscore the potential of gliflozins in geriatric care and their expanding role in chronic disease management.

Main Methods:

  • The study reviews the pharmacological action of gliflozins, focusing on their inhibitory effect on renal glucose and sodium co-transporters.
  • Clinical outcomes associated with gliflozin use, particularly empagliflozin, are examined, including effects on HbA1c, mortality, cardiovascular events, and renal function.
  • The safety profile, including the absence of direct insulin stimulation and risk of hypoglycemia, is discussed.

Main Results:

  • Gliflozins reduce HbA1c by approximately 0.7% and induce weight loss of 2-3 kg through glycosuria.
  • They decrease sodium load, lower blood pressure, and empagliflozin has demonstrated a reduction in all-cause mortality and cardiac decompensation in type 2 diabetic patients.
  • Empagliflozin exhibits nephroprotective effects in both diabetic and non-diabetic individuals.

Conclusions:

  • Gliflozins offer significant benefits in glycemic control, weight management, and cardiovascular and renal protection.
  • Empagliflozin's proven efficacy in reducing mortality and its nephroprotective properties position it as a key therapeutic agent.
  • Given the high prevalence of type 2 diabetes, heart failure, and renal failure, gliflozins are poised for widespread use in geriatric populations and across various chronic diseases.