Which class of diabetes medications is listed as potentially inappropriate to be used with caution in older adults?

• A. SGLT2 inhibitors
• B. GLP-1 receptor agonists
• C. DPP-4 inhibitors
• D. Insulin

Answer: (A)

Beers Criteria flag medications that may cause more harm than benefit in older adults, and one diabetes drug class stands out for requiring caution due to how it can affect volume and blood pressure. SGLT2 inhibitors increase urine output, which can lead to dehydration and orthostatic hypotension. In older patients—who often have reduced kidney function, are on other diuretics, or have frailty—the risk of dizziness, falls, and kidney function changes rises. Because of these safety concerns, this class is listed as something to use with caution in older adults. Other diabetes meds have their own considerations, but they aren’t singled out in the Beers Criteria for this specific caution in the same way.