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Short-Term Risk for Below-Knee Amputation Not Increased With SGLT2i

FRIDAY, Aug. 7, 2020 -- For patients with type 2 diabetes, sodium glucose cotransporter 2 (SGLT2) inhibitors do not increase the risk for below-knee amputation compared with dipeptidyl peptidase 4 (DPP-4) inhibitors, according to a study published online Aug. 5 in Diabetes Care.

Oriana Hoi Yun Yu, M.D., from the Jewish General Hospital in Montreal, and colleagues conducted a multicenter observational study using administrative health care databases to compare the risk for below-knee amputation with SGLT2 inhibitors versus DPP-4 inhibitors among patients with type 2 diabetes. Data were included for 207,817 incident SGTL2 inhibitor users matched to 207,817 DPP-4 inhibitor users.

The researchers found amputation rates of 1.3 and 1.5 per 1,000 person-years among SGLT2 inhibitor users and DPP-4 inhibitor users, respectively, during a mean exposed follow-up time of 11 months. For below-knee amputations, the adjusted hazard ratio was 0.88 (95 percent confidence interval, 0.71 to 1.09) in association with SGLT2 inhibitor use versus DPP-4 inhibitor use. In stratified analyses by specific SGLT2 inhibitor molecule, similar results were obtained.

"Future studies will be needed to further address whether SGLT2 inhibitor use increases the risk of incident below-knee amputation over the longer term," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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