This site is intended for healthcare professionals

Sign in
Go to /sign-in page

You can view 5 more pages without signing in

SGLT2 inhibitors and lower limb amputations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

SGLT2 inhibitors (SGLT2i) and lower limb amputations

  • a systematic review and meta-analysis concluded that (1):
    • there was no consistent evidence of SGLT2i exposure and increased risk of amputation. The increased risk of amputation seen in the large, long-term Canagliflozin Cardiovascular Assessment Study (CANVAS) trial for canagliflozin, and select observational studies, merits continued exploration

  • a Korean database study (n=219900) concluded that (2)
    • initiating SGLT2is against dipeptidyl peptidase-4 inhibitors did not increase the risk of amputation across patient populations of varying vulnerability

  • a review (51 RCTs; n=97,589) found that overall, SGLT-2 inhibitors were associated with an increased risk of peripheral arterial disease (OR 1.20, 95% CI 1.01–1.43, p=0.04), but not amputation (1.18, 0.78–1.79, p=0.43) (3)
    • however, risk was increased for treatment duration >100 weeks
    • the study authors caution that their research has various limitations, and the data therefore need to be interpreted carefully
      • findings emphasise the importance of patient and clinical vigilance in monitoring foot infections and other conditions that can precede amputation

Reference:

  1. Heyward J, Mansour O, Olson L, Singh S, Alexander GC. Association between sodium-glucose cotransporter 2 (SGLT2) inhibitors and lower extremity amputation: A systematic review and meta-analysis. PLoS One. 2020 Jun 5;15(6):e0234065. doi: 10.1371/journal.pone.0234065. PMID: 32502190; PMCID: PMC7274434.
  2. Park, S, Jeong, HE, Bea, S, et al. Safety of sodium-glucose co-transporter-2 inhibitors on amputation across categories of baseline cardiovascular disease and diuretics use in patients with type 2 diabetes. Diabetes Obes Metab. 2023; 1-11. doi:10.1111/dom.15221
  3. Geng L, Sun B, Chen Y. A meta-analysis of randomized controlled studies examining the effects of sodium-glucose co-transporter-2 inhibitors on peripheral artery disease and risk of amputations. Diabetes Obes Metab. 2024; 1-14

Related pages

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.