SGLT-2is Edge GLP-1 RAs on Foot Disease - Scorecard - MDSpire

SGLT-2is Edge GLP-1 RAs on Foot Disease

Danish target trial emulation finds modest neuropathy benefit emerging following year 3, but high discontinuation rates complicate causal interpretation

  • By

  • Kerri Miller

  • January 5, 2026

  • 5 min

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Clinical Scorecard: SGLT-2is Edge GLP-1 RAs on Foot Disease

At a Glance

CategoryDetail
Condition
Key MechanismsSGLT-2 inhibitors reduce peripheral neuropathy risk compared to GLP-1 receptor agonists, but differences are not statistically significant.
Target Population
Care Setting

Key Highlights

  • SGLT-2i users had a 6-year risk of diabetic foot disease at 11%, compared to 12% for GLP-1 RA users (not statistically significant).
  • The reduction in foot disease risk was primarily due to lower peripheral neuropathy risk in SGLT-2i users (statistical significance needed).

Guideline-Based Recommendations

Diagnosis

    Management

      Monitoring & Follow-up

        Risks

        • Be aware of potential increased risk of lower-limb amputation with SGLT-2 inhibitors; monitor patients closely.

        Patient & Prescribing Data

        New users of SGLT-2 inhibitors and GLP-1 receptor agonists.

        Adherence to therapy is crucial for achieving intended pharmacologic effects.

        Clinical Best Practices

        • Ensure regular podiatric assessments for patients on diabetes medications and monitor for detection bias.

        References

        Original Source(s)

        SGLT-2is Edge GLP-1 RAs on Foot Disease

        • by Kerri Miller

        • January 5, 2026

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