دورية أكاديمية
أعرض في EDS

The use of sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists versus sulfonylureas and the risk of lower limb amputations: a nation-wide cohort study.

التفاصيل البيبلوغرافية
العنوان: The use of sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists versus sulfonylureas and the risk of lower limb amputations: a nation-wide cohort study.
المؤلفون: Werkman NCC; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.; Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, The Netherlands., Driessen JHM; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.; Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, The Netherlands.; School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands., Stehouwer CDA; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands., Vestergaard P; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.; Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark., Schaper NC; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands., van den Bergh JP; School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center+, Maastricht, The Netherlands.; Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands., Nielen JTH; Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, The Netherlands. yannick.nielen@mumc.nl.
المصدر: Cardiovascular diabetology [Cardiovasc Diabetol] 2023 Jun 29; Vol. 22 (1), pp. 160. Date of Electronic Publication: 2023 Jun 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2002-
مواضيع طبية MeSH: Diabetes Mellitus, Type 2*/diagnosis , Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/epidemiology , Diabetic Foot*/diagnosis , Diabetic Foot*/epidemiology , Diabetic Foot*/surgery, Humans ; Cohort Studies ; Glucagon-Like Peptide-1 Receptor ; Retrospective Studies ; Sodium-Glucose Transporter 2 ; State Medicine ; Amputation, Surgical/adverse effects ; Lower Extremity ; Glucose ; Sodium
مستخلص: Background: Numerous studies have investigated the potential association of sodium-glucose co-transporter-2 inhibitors (SGLT2-Is) with an increased risk of lower limb amputations (LLAs), but have produced conflicting results. Particularly studies comparing SGLT2-Is to glucagon-like peptide-1 receptor agonists (GLP1-RAs) seem to find a higher LLA risk with SGLT2-I use. This raises the question whether the results are driven by a protective GLP1-RA-effect rather than a harmful SGLT2-I-effect. GLP1-RAs could promote wound healing and therefore reduce the risk of LLAs, but the associations between both drug classes and LLA remain uncertain. Therefore, the aim of the current study was to investigate the risk of LLA and diabetic foot ulcer (DFU) with SGLT2-I use and GLP1-RA use versus sulfonylurea use.
Methods: A retrospective population-based cohort study was conducted using data from the Danish National Health Service (2013-2018). The study population (N = 74,475) consisted of type 2 diabetes patients aged 18 + who received a first ever prescription of an SGLT2-I, GLP1-RA or sulfonylurea. The date of the first prescription defined the start of follow-up. Time-varying Cox proportional hazards models estimated the hazard ratios (HRs) of LLA and DFU with current SGLT2-I use and GLP1-RA use versus current SU use. The models were adjusted for age, sex, socio-economic variables, comorbidities and concomitant drug use.
Results: Current SGLT2-I use was not associated with a higher risk of LLA versus sulfonylureas {adjusted HR 1.10 [95% confidence interval (CI) 0.71-1.70]}. Current GLP1-RA use, on the other hand, was associated with a lower risk of LLA [adjusted HR 0.57 (95%CI 0.39-0.84)] compared to sulfonylureas. The risk of DFU was similar to that with sulfonylureas with both exposures of interest.
Conclusion: SGLT2-I use was not associated with a higher risk of LLA, but GLP1-RAs with a lower risk of LLA. Previous studies reporting a higher risk of LLA with SGLT2-I use compared to GLP1-RA use might have been looking at a protective GLP1-RA effect, rather than a harmful SGLT2-I effect.
(© 2023. The Author(s).)
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فهرسة مساهمة: Keywords: Amputations; Cohort study; Diabetic foot ulcer; Glucagon-like peptide-1 receptor agonists; Sodium-glucose co-transporter-2 inhibitors; Type 2 diabetes
المشرفين على المادة: 0 (Glucagon-Like Peptide-1 Receptor)
0 (Sodium-Glucose Transporter 2)
IY9XDZ35W2 (Glucose)
9NEZ333N27 (Sodium)
تواريخ الأحداث: Date Created: 20230629 Date Completed: 20230703 Latest Revision: 20231122
رمز التحديث: 20231123
مُعرف محوري في PubMed: PMC10311702
DOI: 10.1186/s12933-023-01897-2
PMID: 37386427
قاعدة البيانات: MEDLINE
الوصف
تدمد:1475-2840
DOI:10.1186/s12933-023-01897-2