SGLT2i does not worsen lower-limb amputation risk
10 Oct 2022
The hudud law proposed dictates surgeons to carry out amputation of limbs of criminals so “any damages to the remaining parts of the limb” can be avoided.Among patients with type 2 diabetes (T2D), the use of sodium-glucose cotransporter 2 inhibitors {SGLT2i) does not appear to increase the risk of lower-limb amputation, a recent study has found.
Researchers conducted a retrospective observational cohort study of 107,296 T2D patients, drawing from the Japan Medical Data Vision database. Patients were being treated with either SGLT2i or metformin (control), with each group consisting of 53,648 propensity score-matched patients. The outcome of interest was lower-limb amputation.
Forty-one SGLT2i-treated patients needed amputation, as opposed to 25 in the metformin group. The respective rates were 0.08 percent and 0.05 percent, which did not represent a statistical difference.
Cox proportional hazards analysis revealed that the use of SGLT2i aggravated the risk of lower-limb amputation by nearly 35 percent, though this effect fell short of statistical significance (hazard ratio [HR], 1.34, 95 percent confidence interval [CI], 0.80–2.24).
However, amputation risk remained strongly statistically significant in women on SGLT2i treatment (HR, 2.78, 95 percent CI, 1.12–6.94) and in patients using strong statins (HR, 2.68, 95 percent CI, 1.18–8.20).
“We would like to emphasize that clinicians should pay attention to patients’ foot conditions in routine clinical practice when they prescribe SGLT2is, particularly in female patients with T2D and patients with T2D with suspected advanced atherosclerosis requiring strong statins,” the researchers said.