NDLI: SGLT2 inhibitors and lower limb complications: the diuretic-induced hypovolemia hypothesis

Content Provider	Springer Nature : BioMed Central
Author	Potier, Louis Mohammedi, Kamel Velho, Gilberto Roussel, Ronan
Abstract	In a recent meta-analysis of randomized controlled trials of sodium glucose co-transporter 2 inhibitors (SGLT2i) in patients with diabetes, Lin and colleagues showed a positive association between SGLT2i-induced blood pressure and weight reduction and the risk of lower limb events. These results support the potential mechanism of a volume depletion effect of SGLT2i to explain the increase risk of amputation observed with this pharmacological class. Since the first result of the CANVAS trial raised a concern regarding the risk of amputation with SGLT2i, this hypothesis emerged from studies showing a higher incidence of amputations in patients with diabetes using diuretics. Furthermore, recent data found that copeptin, a surrogate marker of hydration status was also associated with lower limb outcomes. In conclusion, this assumption of diuretic-induced hypovolemia explanation highlights the fact that medications that induce a contraction of plasma volume, both traditional and novel agents with a diuretic mode of action should be introduced cautiously in patients with diabetes at high risk of diabetic foot events.
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-021-01301-x.pdf
Ending Page	3
Page Count	3
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-021-01301-x
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2021-05-13
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology SGLT2 inhibitors lower limb events amputations diuretics hypovolemia
Content Type	Text
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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