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
Authors' conclusion
Initiating SGLT2is against DPP4is did not increase the risk of amputation across patient populations of varying vulnerability. These findings based on routine practice will reassure clinicians of the safety of SGLT2is with regard to amputation risk in selected high-risk patients with type 2 diabetes.
Study context
- Population
- Patients with T2D initiating SGLT2i or DPP-4i, Korea nationwide claims data (2015–2020), classified into four subcohorts by baseline cardiovascular disease (CVD) and diuretic use (DU)
- Participants
- 219,900 propensity score (PS)-matched pairs
- Exposure
- SGLT2i vs DPP-4i
- Outcome
- Amputation
Methodological detailsactive comparator, new-user, nationwide claims data, 1:1 propensity score matched within each subcohort
- Active comparator
- New-user
- Nationwide claims data
- 1:1 propensity score matched within each subcohort
Main finding
As reported in the abstract
Amputation, by subcohort (SGLT2i vs DPP-4i)
SGLT2is vs DPP4isHazard ratio (95% CI)
CVD+/DU+ (n = 11 719)
0.36(0.14–0.90)
CVD+/DU- (n = 26 092)
0.45(0.21–0.99)
CVD-/DU+ (n = 26 894); not significant
0.54(0.26–1.12)
CVD-/DU- (n = 155 195)
0.48(0.33–0.70)
Observational data: associations, not effects.
Further findings
- Consistent trends in estimates across various sensitivity analyses
Original publication
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. Published 28 July 2023. doi:10.
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