OBJECTIVE Diabetic foot ulcer (DFU) is the leading cause of nontraumatic lower-limb amputation (LLA). The impact of sodium/glucose cotransporter-2 inhibitor (SGLT2i) use on LLA is still debated in studies in which the proportion of patients with DFU is unknown. The aim of our study was to determine, specifically in patients with DFU, if the use of an SGLT2i could influence amputation and wound healing. RESEARCH DESIGN AND METHODS This retrospective, monocentric study was conducted in a French specialized diabetic foot center. All patients treated for a new DFU between January 2022 and May 2024 and with 1 year of follow-up were included. The primary end point was 1-year amputation rate. RESULTS Of the 452 patients included in this study, 94 were treated with an SGLT2i and 358 were not. The mean ± SD age of the study population was 70.2 ± 11.6 years and 77% of patients were men. In the adjusted statistical model, there was no significant association between the 1-year amputation rate and SGLT2i use (P = 0.688). The 6-month healing rate was not significantly different between patients treated or not treated with SGLT2is (54.4% vs. 44.5%; P = 0.091). Healing time was significantly less in patients treated with SGLT2is, with a mean ± SD difference of 44 days (136.5 ± 97.8 vs. 181.2 ± 159.8; P = 0.04). The 1-year mortality rate was significantly lower in the SGLT2i group (1.1% vs. 9.2%; P = 0.009). CONCLUSIONS The use of SGLT2is does not negatively impact the 1-year amputation rate or healing rate of DFU. One-year mortality was lower in patients treated with an SGLT2i.
Dumortier et al. (Wed,) studied this question.