Do diabetes pills (SGLT2 inhibitors) also work against ageing?
For people with heart or kidney problems, large studies in people show clearly that these pills do considerably more than lower blood sugar. As an anti-ageing pill for healthy people, it is too early for any practical advice.
Empagliflozin and dapagliflozin are diabetes pills that prompt the kidneys to dispose of excess sugar through urine. Many large studies in people show that, even in people without diabetes, they substantially reduce the risk of heart failure, kidney failure, and premature death. That is solid evidence that they do more than simply lower blood sugar.
At the cell level, these pills do something similar to eating less, a well-known way to slow ageing. Cells become better at clearing out damaged parts. However, we know this mainly from experiments with cells and animal studies so far. Direct confirmation in people is still largely lacking.
These pills also appear to dampen the low-grade, smouldering inflammation that grows over the years and contributes to heart disease and dementia. Both animal studies and studies in people show lower inflammation markers. Those studies were not specifically designed as ageing research, however.
A clever genetic study found a link between lifelong SGLT2 lowering and a longer lifespan (on average 6.2 years for the father per standard-deviation drop in average blood sugar) and better cognition. It sounds impressive, but this is not a direct measurement in people taking the pill. The method has serious limitations and the findings are far from proven.
In a large study of more than 280,000 patients, these pills protected the kidneys better than another popular diabetes pill, including in frail older adults. The risk of dialysis or kidney transplant was 2.4 to 3.9 times higher with that other pill. Two caveats: there is almost no research on how these pills interact with exercise, while some medicines can undermine the benefits of physical activity. And an article promoting supplements as a way to boost these pills comes from authors with financial ties to supplement companies; the evidence for that claim is weak.
The claims are based on large studies in people (heart and kidney outcomes), one large study tracking patients over time (Taiwan, n=280,000+), a genetic method known as Mendelian randomisation, mechanistic studies and experiments with cells and animals, and a review with possible conflicts of interest. No studies have used lifespan or biological ageing as their primary outcome. Many studies combined were not used as a direct source, though large individual studies in people were included.
Does diabetes make a person age faster biologically?
Yes, diabetes measurably accelerates biological ageing: the risk of cardiovascular disease, dementia and early death increases, and keeping blood sugar well controlled is the most direct way to slow that process.
What does insulin do to the ageing process?
Chronically too much insulin is probably bad for healthy ageing, but science does not yet know precisely what the ideal insulin balance is for you. Eating less processed food and moving more are the best-supported steps for keeping your insulin metabolism in good shape.
Does insulin resistance accelerate ageing?
Insulin resistance is associated with measurably faster biological ageing, greater muscle loss, and possibly a higher risk of cognitive decline. Regular physical exercise is the best-supported way to slow this down.
What does stable blood sugar do for healthy ageing?
A stable, low blood sugar is associated worldwide with more healthy life years. The association is clear, but the exact gain per individual cannot be quantified on the basis of this research.
Does excess weight accelerate ageing?
Excess weight demonstrably accelerates biological ageing, but metabolic health counts at least as heavily as the number on the scale. Losing weight and exercising help, and the earlier you start, the greater the benefit.
Does eating a lot of sugar give you type 2 diabetes?
Sugary drinks clearly and demonstrably raise your risk of type 2 diabetes. Sugar from solid food barely does. The biggest difference comes from drinking fewer sugary drinks, moving more, and losing weight.