Amputations differ by drug in type 2 diabetes with leg artery disease
Among adults with type 2 diabetes and leg artery disease, one-year minor amputation rates were 1.0% for drugs such as semaglutide versus 1.6% for drugs such as empagliflozin.
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Adults aged 18 or older with type 2 diabetes and lower-limb artery disease or chronic leg ulcers were compared in an observational study of health records. Each matched group included 37,225 people, with an average age of 65; 57% were male. They started one of two diabetes drug classes during 2017–2025: glucagon-like peptide-1 receptor agonists, including semaglutide, or sodium-glucose cotransporter-2 inhibitors, including empagliflozin.
Researchers matched the groups on more than 40 characteristics. At one year, major amputations occurred in 0.2% of the first group versus 0.4% of the second. Bone infections occurred in 2.8% versus 3.5%. Catheter-based procedures to restore blood flow in leg arteries occurred in 1.6% versus 2.6%. The first drug class was associated with lower risks of these outcomes and minor amputations through five years.
Why it matters
For people managing type 2 diabetes and leg artery disease in later life, the comparison bears on medication choice beyond heart and stroke risks. The authors supported considering glucagon-like peptide-1 receptor agonists for people with both conditions.
Caveats
Matching could not rule out unmeasured differences in leg disease severity or prescribing choices that could have affected limb outcomes. The findings were reported in a conference abstract and do not address people without type 2 diabetes or lower-limb disease.
The paper
Mercy Catholic Med Cntr; Sections of Clinical Cardiology and Vascular Medicine Robert and Suzanne Tomsich Dept of Cardiovascular Medicine
AHA Scientific Sessions 2026 Abstract, Nov 2, 2026
Presented at AHA Scientific Sessions 2026, abstract 15857
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