Diuretics and risk of major adverse limb events in patients with type-2 diabetes: An observational retrospective study
Authors' conclusion
Diuretic treatment weighting may be associated with increased risk of MALEs. We identified several markers of increased risk of limb events where the use of diuretics should be considered with caution.
Study context
- Population
- Consecutive T2D patients without cardiovascular history referred for cardiovascular check-ups; 59.5 ± 10.7 years, 51 % females, diabetes duration 9.1 ± 8.5 years
- Participants
- 1,309 patients
- Exposure
- Diuretics vs no diuretics
- Diureticsn = 402
- Outcome
- MALEs (and amputation alone)
- Follow-up
- 3.8 ± 1.64 years
Methodological detailsobservational, Cox models, propensity score, IPTW analysis
- Observational
- Cox models
- Propensity score
- IPTW analysis
Main finding
As reported in the abstract
MALEs
Diuretics vs No diureticsAdjusted hazard ratio (95 % CI)P value
Multivariable analysis
1.96(1.32–2.91)
P = 0.001Adjusted on propensity score
1.66(1.08–2.56)
P = 0.02IPTW analysis
1.76(1.67–1.84)
P < 0.0001- Major adverse limb events (MALEs), all patients
- 121 (9.1 %)
- Amputations, all patients
- 19 (1.4 %)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (CI) | P value | |
|---|---|---|---|
| MALEs with abnormal ankle-brachial index at baseline | 2.29 (1.32–3.96) | P = 0.003 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
MALEs by diuretic class
| aHR (CI) | P value | ||
|---|---|---|---|
| Loop diuretics | 2.56 (1.16–5.64) | P = 0.020 | |
| Thiazides | 2.21 (1.37–3.57) | P = 0.001 | |
| Potassium sparing diuretics | 2.56 (1.16–5.64) | P = 0.020 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Death · proportions of deaths, as printed
P = 0.001
- Death — Deaths, all patients
- 111
Original publication
Diuretics and risk of major adverse limb events in patients with type-2 diabetes: An observational retrospective study. Diabetes Metab. Published 3 October 2024. doi:10.
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