Endocrine Abstracts

Introduction: The use of iSGLT2 continues to be controversial in diabetic patients with peripheral arterial disease.

Objectives: Assess the metabolic effect and the risk of amputations of iSGLT2 in diabetic patients cared for in the Multidisciplinary Diabetic Foot Unit (MDFU) compared to a control group.

Material and Methods: A retrospective observational study where patients attended at the MDFU from December 2017 to January 2020 were recruited. An iSGLT2 treatment group was selected and these data were compared with a control group. Clinical, metabolic, anthropometric variables and amputation rate were collected in both arms. Statistical analysis was performed using the SPSS program (SPSS, inc, v15.0).

Results: A total of 312 patients were recruited: 83 in treatment with iSGLT2 and 229 as a control group. The treatment group had a mean age of 65.99 ± 10.31 vs 68.14 ± 12.11 (P = 0.12) years of the control group and a time of evolution of the disease of 17.33 ± 10.26 vs 18.10 ± 11.97 (P = 0.52). Weight of 86.88 ± 17.77 kg vs 82.65 ± 15.65 kg (P = 0.57) and a mean BMI 31.07 ± 5.61 kg/m² vs 29.58 ± 4.91 kg/m² (P= 0.03). HbA1c at baseline (iSGLT2 vs control group): 8.83 ± 1.67% vs 7.71 ± 1.72% (P = 0.00); mean reduction: 1.04 ± 1.32% vs 1.42 ± 2.34% (P = 0.38); Final HbA1c: 8.08 ± 1.37 vs 7.42 ± 1.32% (P = 0.05). There were no statistically significant differences between the LDL values at baseline (96.29 ± 38.95 mg/dl vs 98.8 ± 40.93 mg/dl, P = 0.67)) or between the reductions obtained in both arms (11.28 ± 31.16 vs 12.25 ± 31.84, P = 0.91). Taking into account some risk factors for an amputation to occur, there was a higher proportion of hypertension (78.3% vs 72.2%), dyslipemia (74.7 vs 71.1%), smokers (58.2 vs 49.8%) in the group with iSGLT2, as well as a longer history of chronic ischemia (41 vs 38.2%) and neuropathy (74.4 vs 70.9%). The amputation rate after follow-up was 15.7% in the iSGLT2 group compared to the control group 12.3% (P = 0.55).

Conclusions: This study shows that the treatment with iSGLT2 in a group of patients with peripheral arterial disease is effective and safe, not increasing the rate of amputations compared to the rest of the patients attended in the MDFU, despite having a higher number of risk factors for this.