{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:49:25Z","timestamp":1791427765257,"version":"4.3.3"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate the association of initiating glucagon\u2010like peptide\u20101 receptor agonists versus dipeptidyl peptidase\u20104 inhibitors (as active comparator) with frailty progression and falls and whether associations differed by baseline frailty.<\/jats:p>\n <\/jats:sec>\n \n Research Design and Methods<\/jats:title>\n Five propensity score\u2010matched retrospective cohorts using Veterans Health data (years 2006\u20132021), utilizing new\u2010user, active\u2010comparator design. The five matched cohorts were at progressive degrees of frailty at baseline and included adults with diabetes and 3\u2009years of baseline data who initiated study medications with at least 90\u2009days of therapy.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcome was absolute change in Frailty Index from baseline to follow\u2010up. Secondary outcomes were increase in the frailty index and fall rate during follow\u2010up. Outcomes were assessed in an as\u2010treated framework.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The main matched cohort included 73\u2009592 pairs. Over a mean follow\u2010up of approximately 27\u2009months, glucagon\u2010like peptide\u20101 receptor agonists initiation was associated with less worsening in frailty index (regression coefficient: \u22120.0010; 95% CI: \u22120.0018 to \u22120.0002;\n p<\/jats:italic>\n \u2009=\u20090.011), lower odds of frailty index progression (OR: 0.97; 95% CI: 0.95\u20130.99;\n p<\/jats:italic>\n \u2009=\u20090.003), and a lower fall rate (incidence rate ratio: 0.87; 95% CI: 0.84\u20130.91;\n p<\/jats:italic>\n \u2009<\u20090.001) compared to dipeptidyl peptidase\u20104 inhibitor initiation. Findings were generally consistent across the other four matched cohorts, with attenuation in the matched cohort with severe frailty at baseline.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Initiation of glucagon\u2010like peptide\u20101 receptor agonist was associated with slightly less frailty progression and fewer falls compared with dipeptidyl peptidase\u20104 inhibitor initiation, but estimates were attenuated in severe frailty.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71377","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:51:33Z","timestamp":1791424293000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of\n GLP1<\/scp>\n \u2010Receptor Agonist Use With Frailty and Falls in Adults With Type 2 Diabetes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4270-241X","authenticated-orcid":false,"given":"Shuyao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine\/Endocrinology UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7006-7401","authenticated-orcid":false,"given":"Ildiko","family":"Lingvay","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Endocrinology UT Southwestern Medical Center Dallas Texas USA"},{"name":"Peter O'donnell Jr School of Public, UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6122-3716","authenticated-orcid":false,"given":"Ishak","family":"Mansi","sequence":"additional","affiliation":[{"name":"Education Services Orlando VA Health Care System Orlando Florida 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