A retrospective cohort in a regional health system compared new initiators of GLP-1 receptor agonists, SGLT2 inhibitors and DPP-4 inhibitors among 58,754 adults aged 65 and over with type 2 diabetes, 2018-2026. GLP-1 initiators were younger (17.7% aged 80 and over against 35.0% and 47.6%), heavier (72.1% with BMI 30 or above against 41.9% and 34.0%) and had less dementia, heart failure and renal disease, with fewer hospitalisations in the prior year. BMI above 27 kg/m2 was the strongest positive predictor of GLP-1 initiation, and heart failure and prior hospitalisation the strongest negative ones.
Why it is interesting: Quantifies how far GLP-1 starters differ at baseline from starters of other diabetes drugs, in age, adiposity and comorbidity.