According to a large population-based study from Denmark, individuals with type 2 diabetes who start therapy with SGLT-2 inhibitors may have a somewhat reduced chance of developing diabetic foot issues than those taking GLP-1 receptor agonists. The findings, published in the Annals of Internal Medicine, add to growing evidence that current diabetes medications may have advantages apart from blood sugar management. 

Scientists from Aarhus University and Aarhus University Hospital evaluated national health registry data from approximately 84,000 Danish people with type 2 diabetes. Participants began therapy with either SGLT-2 inhibitors or GLP-1 receptor agonists between 2013 and 2023 and were monitored for up to six years. 

Diabetic foot disease is a severe form of diabetes. It can cause nerve damage, poor blood flow, foot ulcers, and, in extreme cases, amputations. Nerve damage, often known as neuropathy, impairs sensation in the feet, making injuries harder to detect and slower to cure. 

According to the study, 10.8% of individuals taking SGLT-2 inhibitors acquired diabetic foot disease throughout the study period, compared to 12% of those taking GLP-1 receptor agonists. The difference became apparent after around three years, and it was mostly attributed to fewer incidences of nerve injury among SGLT-2 users. 

"The overall difference was modest," the researchers stated, noting that the incidence of leg ulcers, amputations, leg artery issues, and mortality were relatively comparable in both therapy groups. This implies that, while nerve protection may offer a little benefit, both medications function similarly for the majority of adverse outcomes. 

SGLT-2 inhibitors assist the kidneys in eliminating excess sugar through urine, whereas GLP-1 receptor agonists boost insulin release and suppress hunger. Both are often used in type 2 diabetes and are proven to benefit the heart and kidneys. 

The authors suggested care in interpreting the findings. They noted that many patients discontinued or switched medications during the research period, a phenomenon known as treatment crossover. Differences in how closely patients were examined for foot issues might potentially have impacted the results. "These factors make it uncertain whether the observed difference reflects a true drug effect," the researchers added. 

Nonetheless, the researchers concluded that the study provides more evidence that both pharmacological types give additional health advantages. The findings may assist doctors in making treatment decisions for patients who are already at high risk of diabetic foot disease, in addition to regular foot care and glucose management.