These diabetes drugs are finding new life as an antiaging hack

Mint

a day ago

Some health-obsessed Americans believe the next antiaging therapeutic already exists—in the medicine cabinets of millions of diabetes patients.
The widely used class of drugs, called SGLT2 inhibitors and sold under brand names such as Jardiance and Farxiga, have been on the market for over a decade as Type 2 diabetes medications. They have also gained regulatory approval to treat conditions like heart failure and kidney disease.
Recently, though, the drugs have emerged as a hot topic on popular health podcasts and Reddit forums for longevity enthusiasts, many of whom don't suffer from any of those conditions. Instead, they are adding SGLT2 inhibitors to a roster of hacks they hope will help them live healthier for longer—or in other words, increase their healthspan.
The drugs work by helping the kidneys release extra glucose from the body through urine, improving blood-sugar levels. While there are no studies of whether they can extend the lives of healthy humans, a growing body of evidence shows they help protect against multiple age-related diseases and reduce mortality rates for patients with certain chronic conditions. Some researchers believe they may also affect the fundamental biology of aging.
'This is probably the drug class of our era," says Dr. Timothy Gong, section physician leader for heart failure and transplant cardiology at Baylor University Medical Center, who has researched SGLT2 inhibitors. 'You see cardiologists, nephrologists, endocrinologists, even general internists as well, just getting so excited."
Gong says he wouldn't be surprised to take an SGLT2 inhibitor one day, once they are studied more, though he's free from heart issues and diabetes. Yet it's too early to prescribe it for longevity benefits in otherwise healthy patients.
'I don't think that the evidence is strong enough yet for us to be able to say that," he says.
Right now, use of SGLT2 inhibitors for potential antiaging benefits is limited mostly to a growing community of so-called biohackers, who seek to optimize their health through experimentation with gadgets, behaviors and various medicines and supplements. Because most take it off-label—meaning, for a nonapproved use—the drugs typically aren't covered by insurance and can cost hundreds of dollars a month out of pocket.
Dave Aiello, a Boston chiropractor who doesn't have diabetes, began experimenting with the drugs after learning about a promising study in mice. The 38-year-old wanted to get ahead of health problems but was disenchanted by what he saw as a reactive approach to disease in conventional medicine.
'I'm trying to see if I can just stay as healthy as possible for as long as possible," says Aiello, who has been taking an SGLT2 inhibitor called empagliflozin since 2022.
He also takes the kidney-transplant drug rapamycin off-label and has previously taken the diabetes pill metformin—both of which have gained traction as potential longevity boosters, too. He was particularly impressed by research showing SGLT2 inhibitors can help the body manage blood sugar more efficiently, which in turn supports cardiometabolic health.
He says he's encouraged by the results so far: Between 2022 and 2024, Aiello's hemoglobin A1C, a measure of average blood sugar, fell to 4.6% from 5.1%, his laboratory test results show.
The drugs aren't free of potential side effects, including increased risk of urinary-tract infections, dehydration, and in rare cases, severe genital infections and a life-threatening condition called diabetic ketoacidosis.
When Aiello first started taking empagliflozin, he felt dehydrated and experienced fatigue and brain fog. Those side effects have subsided since he decreased his dose and has made sure to take in more electrolytes.
'I'm a little more willing to take some risks that could potentially affect me in the short term if I do think that there might be a benefit," Aiello says.
It isn't clear precisely how SGLT2 inhibitors might protect against the ravages of aging, but the research in mice offers clues. In 2020, a National Institute on Aging-funded study found that one SGLT2 inhibitor called canagliflozin extended the lives of male—but not female—mice by 14%.
One theory is that the drugs help slow the aging process partly by blunting blood-sugar spikes. Scientists say that by driving insulin levels down, these drugs promote fat burning and create an anti-inflammatory effect that mimics calorie restriction, which studies suggest can slow the pace of aging.
Still, many drugs that work in mice don't work in humans, says Richard A. Miller, who led the study and is director of the Glenn Center for Biology of Aging Research at the University of Michigan.
His lab is now studying how the small molecules inside slow-aging mice change over time. If a drug in humans produces these same metabolomic shifts seen in slow-aging mice, he says, it would provide more confidence that it could slow aging in people.
'We still have a lot of work to do to prove that the drugs do the same thing in people," says Miller. 'The hint here is that it's actually slowing the aging rate."
Alan Vuong, who works in sales in Austin, Texas, started taking the SGLT2 inhibitor dapagliflozin this year after hearing a podcast interview with Miller. The 34-year-old has a family history of Type 2 diabetes and wanted to lower his fasting insulin level, a measure of metabolic health, from normal to optimal.
He spends about $150 a month on his longevity protocol, which includes a dozen drugs and supplements, and has seen his insulin levels drop since starting the medication. Other than having to use the bathroom in the middle of the night more often, a known side effect of the drugs, Vuong hasn't noticed other physical side effects.
'My end goal is to extend lifespan, but more importantly, healthspan," he says. 'I'm willing to take that gamble."