CHICAGO -- Use of GLP-1 receptor agonists was tied to significantly lower risks of major diabetic foot complications compared with SGLT2 inhibitors in adults with type 2 diabetes, a large, real-world analysis indicated.
Compared with GLP-1 drug use, use of SGLT2 inhibitors was associated with higher risks of the following over a 5-year follow-up period (P<0.001 for all):Osteomyelitis: risk ratio (RR) 1.30 (95% CI 1.26-1.35)Diabetic foot ulcers: RR 1.11 (95% CI 1.09-1.13)Lower-extremity amputation: RR 1.24 (95% CI 1.20-1.28)
However, SGLT2 inhibitor therapy was linked with a very small but significantly lower risk of new-onset diabetic peripheral neuropathy (RR 0.97, 95% CI 0.93-0.98, P<0.001), reported Christie Polycarpe, DO, of Jefferson Einstein Philadelphia Hospital in Pennsylvania, at ENDO 2026, the annual meeting of the Endocrine Society.
Lower neuropathy risk did not mean fewer foot events, Polycarpe pointed out, as diabetic foot disease is multifactorial. "These findings underscore the multifactorial nature of diabetic foot disease and suggest that neuropathy risk alone may not fully account for downstream foot complications," the researchers acknowledged in their abstract.
Given the widespread use of these therapies, understanding their association with limb-related outcomes has important clinical implications, Polycarpe emphasized.
