SGLT2 inhibitors after 75 show no excess harm in a Canadian cohort

The edition in brief

In 4,997 SGLT2 inhibitor and 1,289 DPP-4 inhibitor initiators aged 75 or older in British Columbia, starting an SGLT2 inhibitor was associated with less acute kidney injury (HR 0.76, 0.60–0.95) and fewer hospitalisations (HR 0.87, 0.77–0.98), with no difference in infection, ketoacidosis, falls or fractures, though several of those estimates were imprecise. A target-trial emulation in 3,200 people with diabetes on maintenance haemodialysis linked semaglutide, against dulaglutide or liraglutide, to lower death on dialysis (sHR 0.82, 0.70–0.97) and fewer admissions; the benefit held against dulaglutide but not liraglutide. A genetic study of 1,129 insulin-treated people referred for MODY testing estimated that about one in five actually had type 1 diabetes, and that a type 1 genetic risk score could spare more than half of tests in children under 10. The FDA lists further Class II recalls of compounded tirzepatide and semaglutide products for lack of sterility assurance. The pearl covers sick-day rules when an older adult on an SGLT2 inhibitor stops eating.