SGLT2 Inhibitors Linked to Higher Risk of PAD Surgeries Compared to DPP-4 Inhibitors in Veterans with Diabetes: Study
USA: A recent study has found that in older veterans with type 2 diabetes (T2D), adding sodium-glucose cotransporter 2 (SGLT2) inhibitors to treatment is linked to a higher risk of surgical events related to peripheral artery disease (PAD) compared to the use of dipeptidyl peptidase 4 (DPP-4) inhibitors. The findings were published online in Diabetes Care on December 2, 224.
Some placebo-controlled randomized trials have suggested an increased risk of amputation with SGLT2 inhibitors in patients with underlying cardiovascular diseases, though this finding remains unconfirmed by subsequent trials. Considering this, Christianne L. Roumie, Geriatric Research Education Clinical Center, Tennessee Valley Health Care System, Nashville, TN, and colleagues compared the risk of composite peripheral artery disease surgical outcomes, including peripheral revascularization and amputation procedures, between new users of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and dipeptidyl peptidase 4 inhibitors (DPP-4is).
For this purpose, the researchers conducted a retrospective cohort study of U.S. veterans aged 18 and older with diabetes, receiving care from the Veterans Health Administration, from 2000 to 2021. Data were linked to Medicare, Medicaid, and the National Death Index. The study evaluated the new use of SGLT2is or DPP-4is as an add-on to metformin, sulfonylurea, or insulin treatments, alone or in combination, and its association with PAD surgical procedures, including peripheral revascularization and amputation.
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