|Recommendation||Strength of the recommendation||Quality of the evidence|
|The patient is taking DPP-4 inhibitors and HbA1c is <8.5% (70 mmol/mol). Please reconsider the use of gliptins for the management of type 2 diabetes in older adults because of scarce data on clinically relevant benefits of their use. Please take the patient’s symptoms into consideration.||
Reason: No trial data supporting long-term clinically-relevant benefits in older people. One RCT pointing at possible adverse long-term effects independently from age.
|The evidence was graded low quality. It was considered to downgrade the quality of the evidence to low quality because there were study limitations (1 observational study and a pooled analysis), indirectness (most of the studies did not report data in older people, apart from the pooled analysis), inconsistency (different types of DPP-4 inhibitors evaluated), and lack of data of long-term benefits under DPP-4 inhibitors in older people.|