Endocrine Abstracts

Introduction

The use of iSGLT2 remains controversial in diabetic patients with peripheral arterial disease.

Objectives

Assess metabolic effect and risk of amputations of iSGLT2 in diabetic patients treated in the Multidisciplinary Unit of Diabetic Foot (MUDF) comparatively with a control group.

Design and methods

Retrospective observational study in which the patients seen at the MUDF from December 2017 to January 2021 were recruited. A treatment group with iSGLT2 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, v21.0).

Results

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 years of the control group (P = 0.12) and a disease evolution time 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 of 31.07 ± 5.61 kg/m² vs 29.58 ± 4.91 kg/m² (P = 0.03). Basal HbA1c (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 vs7.42 ± 1.32% (P = 0.05). No statistical significant differences between the basal LDL values ​ (96.29 ± 38.95 mg/dl vs 98.8 ± 40.93 mg/dl, P = 0.67)) or the reductions obtained in both arms (11, 28 ± 31.16vs12.25 ± 31.84, P = 0.91). Risk factors for amputation: higher proportion of hypertension (78.3% vs 72.2%), dyslipidemia (74.7 vs 71.1%), smokers (58.2 vs 49.8%) in the group with iSGLT2, as well as a greater history of chronic ischemia (41 vs 38.2%) and neuropathy (74.4 vs 70.9%). The rate of amputations after follow-up was 15.7% in the iSGLT2 group compared with the 12.3% control group (P = 0.55).

Conclusions

This study shows that treatment with iSGLT2 in a group of diabetic patients with a high risk of amputations is effective and safe, not increasing this rate comparing with control group of MUDF, despite presenting greater number of risk factors for it.