Lower limb events in individuals with type 2 diabetes: evidence for an increased risk associated with diuretic use

Diabetologia
Louis PotierSamy Hadjadj

Abstract

Recently, safety data signalled an increased risk of amputations in people taking canagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. If this side effect is due to drug-induced hypovolaemia, diuretics should also increase that risk. The aim of this study was to analyse the association between diuretic use and the risk of lower limb events (LLEs) in people with type 2 diabetes. SURDIAGENE (SUivi Rénal, DIAbète de type 2 et GENEtique) is a prospective observational cohort that includes people with type 2 diabetes enrolled from 2002 to 2012 and followed-up until onset of LLE, death or 31 December 2015, whichever came first. Primary outcome was the first occurrence of LLE, a composite of lower limb amputation (LLA) and lower limb revascularisation (LLR). The rates of primary outcome were compared between participants taking and not taking diuretics at baseline in a Cox-adjusted model. At baseline, of the 1459 participants included, 670 were taking diuretics. In participants with and without diuretics, the mean ages were 67.1 and 62.9 years and 55.8% and 59.8% were men, respectively. During a median follow-up of 7.1 years, the incidence of LLE was 1.80 per 100 patient-years in diuretic users vs 1.00 in non-users (p < ...Continue Reading

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Citations

Mar 29, 2019·Expert Opinion on Pharmacotherapy·Emanuel RaschiFabrizio De Ponti
Nov 9, 2019·The International Journal of Lower Extremity Wounds·Eleni PapadokostakiEvangelos N Liberopoulos
May 22, 2020·Diabetes, Obesity & Metabolism·Clare ArnottBruce Neal
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May 10, 2020·American Journal of Therapeutics·Anne MisherRobin Southwood
Mar 7, 2021·International Journal of Molecular Sciences·Federico BiscettiAndrea Flex
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Dec 19, 2021·Drugs & Aging·Gunjan Y Gandhi, Arshag D Mooradian

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