{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:00:14Z","timestamp":1790190014324,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/Introduction<\/jats:title>\n                    <jats:p>Sodium\u2010glucose cotransporter 2 inhibitors (SGLT2is) are increasingly prescribed to older adults; however, data regarding their tolerability and drug\u2010specific adverse events (AEs) in very elderly Asian populations, particularly among individuals with frailty or low body mass index (BMI), remain limited. We aimed to determine the incidence of SGLT2i\u2010specific AE\u2010related treatment discontinuation and to identify associated risk factors among Japanese adults aged \u226575\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective cohort study including Japanese adults aged \u226575\u2009years who newly initiated SGLT2is between 2014 and 2024. Medical records were reviewed for 180\u2009days. SGLT2i\u2013specific AEs were defined as genitourinary infection, volume depletion, acute kidney function decline, and diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome. Cox proportional hazards models were used for identifying predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 616 patients were included (mean age, 81.3\u2009years; mean BMI, 24.0\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). The 180\u2010day cumulative incidence of SGLT2i\u2010specific AE\u2010related discontinuation was 9.1%. Multivariable analysis identified Clinical Frailty Scale \u22655 (hazard ratio [HR], 4.67;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and BMI &lt;22\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (HR, 2.53;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) as independent predictors of discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SGLT2 inhibitors were generally well tolerated among adults aged \u226575\u2009years. Frailty and low BMI were the principal determinants of AE\u2010related treatment discontinuation, whereas chronological age was not independently associated with the risk. Assessment of physiological reserve may help identify patients requiring closer monitoring and support the safe use of SGLT2 inhibitors in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70424","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:52:25Z","timestamp":1787309545000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Frailty and low body mass index as key determinants of sodium\u2010glucose cotransporter 2 inhibitor\u2010specific adverse event\u2010related discontinuation in adults aged \u226575\u2009years: A\u00a0multicenter real\u2010world retrospective cohort study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-4901","authenticated-orcid":false,"given":"Taisuke","family":"Uchida","sequence":"first","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4947-594X","authenticated-orcid":false,"given":"Hiroaki","family":"Ueno","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Konagata","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3175-5460","authenticated-orcid":false,"given":"Hiroki","family":"Nabekura","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Beppu","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akari","family":"Sekishima","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Sekishima","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiko","family":"Kogo","sequence":"additional","affiliation":[{"name":"Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine University of Miyazaki  Miyazaki 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