Longitudinal association of SGLT2 inhibitors and GLP-1RAs on falls in persons with type 2 diabetes

Abstract

Low lean body mass increases fall risk. Some diabetes medications, specifically SGLT2 inhibitors and GLP-1RAs, can cause muscle and body mass loss. This study assessed their association on falls in type 2 diabetes patients. An annual fall survey was conducted for up to 5 years on individuals with type 2 diabetes admitted to our department. Fall risk factors were identified using discrete-time survival analysis. The study observed 471 participants over a median period of 2 years. The participants had a median age of 64 years, with a fall incidence rate of 17.1 per 100 person-years. Independent fall predictors identified were fall history, SGLT2 inhibitor use, and age. The odds ratios (95% confidence intervals) for using SGLT2 inhibitors only, GLP-1RAs only, and both combined were 1.80 (1.10–2.92), 1.61 (0.88–2.84), and 2.89 (1.27–6.56), respectively. SGLT2 inhibitor use was an independent risk factor for falls, while GLP-1RAs’ effects were not statistically significant. However, the combined use of SGLT2 inhibitors and GLP-1RAs significantly increased the risk of falls. Therefore, it is important to consider this risk when prescribing these medications to people with type 2 diabetes.