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Abstract As prescribing of newer antihyperglycemic agents expands, there remains limited comparative safety data for older adults—a population particularly vulnerable to adverse drug events and underrepresented in clinical trials. We conduct a multinational cohort study using nine databases from the U.S. and Europe. Among adults aged ≥65, we compare eighteen safety outcomes across four classes of second-line antihyperglycemic agents.
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1. Introduction Diabetes affects approximately 550 million people (9.3% of the population) worldwide, and the prevalence is projected to increase to 643 million by the year 2030 [1,2]. Of people with diabetes, 34% develop a diabetic foot ulcer (DFU) during their lifetime, half of their DFUs become infected, 20% require hospitalization, 5% lead to lower extremity amputation (LEA), and half of those LEAs lead to LEA of the opposite limb within 5 years [3,4,5,6,7].
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