Incretin-based therapy and the risk of diabetic foot ulcers and related events.
Diabetes Obes Metab
; 26(9): 3764-3780, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38951877
ABSTRACT
AIM:
To investigate the effect of dipeptidyl peptidase-4 inhibitors (DPP4-Is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) on diabetic foot ulcer (DFU) and DFU-related outcomes (lower limb amputation [LLA], DFU-related hospitalization and mortality).METHODS:
We performed a cohort study with data from the Clinical Practice Research Datalink Aurum database with linkage to hospital data. We included people with type 2 diabetes starting treatment with metformin. Then we propensity score matched new users of DPP4-Is and sulphonylureas (N = 98 770), and new users of GLP1-RAs and insulin (N = 25 422). Cox proportional hazards models estimated the hazard ratios (HRs) for the outcomes.RESULTS:
We observed a lower risk of DFU with both DPP4-I use versus sulphonylurea use (HR 0.88, 95% confidence interval [CI] 0.79-0.97) and GLP1-RA use versus insulin use (HR 0.44, 95% CI 0.32-0.60) for short-term exposure (≤ 400 days) and HR 0.74 (95% CI 0.60-0.92) for long-term exposure (>400 days). Furthermore, the risks of hospitalization and mortality were lower with both DPP4-I use and GLP1-RA use. The risk of LLA was lower with GLP1-RA use. The results remained consistent across several sensitivity analyses.CONCLUSIONS:
Incretin-based therapy was associated with a lower risk of DFU and DFU-related outcomes. This suggests benefits for the use of this treatment in people at risk of DFU.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pé Diabético
/
Diabetes Mellitus Tipo 2
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Inibidores da Dipeptidil Peptidase IV
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Incretinas
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Receptor do Peptídeo Semelhante ao Glucagon 1
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Amputação Cirúrgica
/
Hipoglicemiantes
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Diabetes Obes Metab
Assunto da revista:
ENDOCRINOLOGIA
/
METABOLISMO
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Holanda