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Loss of skeletal muscle mass is a known risk factor for falls. Researchers from the University of Tsukuba conducted a 5-yr follow-up study on 471 patients with type 2 diabetes and found that sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of diabetes medications with significant weight-reducing effects, increase the risk of falls. Moreover, they also observed that the risk further rises when SGLT2 inhibitors are used in combination with glucagon-like peptide-1 (GLP-1) receptor agonists.

Tsukuba, Japan—Patients with low skeletal muscle mass are at a higher risk of falling. Certain diabetes medications, particularly SGLT2 (SGLT2) inhibitors and GLP-1 (GLP-1) receptor agonists, are associated with weight reduction, which may contribute to muscle mass loss and, consequently, an increased risk of falls. To explore this association, researchers investigated the impact of diabetes medications on fall risk in patients with type 2 diabetes.

The study involved a longitudinal follow-up of 471 patients (median age: 64 yr) who were admitted to the Department of Endocrinology, Diabetes, and Metabolism at the University of Tsukuba Hospital. Following their discharge, annual fall-related questionnaire surveys were conducted for up to 5 yr. The researchers reported a fall incidence rate of 17.1 falls per 100 person-years.

A detailed analysis identified three significant risk factors for falls: a history of falls at the time of hospitalization, the use of SGLT2 inhibitors at discharge, and advanced age. While GLP-1 receptor antagonists alone did not significantly influence fall risk, the combination of SGLT2 inhibitors and GLP-1 receptor antagonists resulted in a higher incidence of falls compared with SGLT2 inhibitors monotherapy.

These findings underscore the importance of monitoring fall risk in patients prescribed SGLT2i, particularly those also receiving GLP-1RA. Healthcare providers should implement appropriate dietary and exercise interventions to mitigate muscle loss and reduce fall risk following hospital discharge in patients with type 2 diabetes.

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This work was supported by JSPS KAKENHI Grant-in-Aid for Early-Career Scientists JP24K20536.

Original Paper

Title of original paper:

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

Journal:

Scientific Reports

DOI:

10.1038/s41598-025-91101-0

Correspondence

Professor SHIMANO Hitoshi
Institute of Medicine, University of Tsukuba

Assistant Professor SUZUKI Yasuhiro
Institute of Systems and Information Engineering, University of Tsukuba

Professor SUZUKI Hiroaki
Department of Food and Health Sciences, Faculty of Human Life Sciences, Jissen Women's University

Related Link

Institute of Medicine

Institute of Systems and Information Engineering