The use of sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists versus sulfonylureas and the risk of lower limb amputations: a nation-wide cohort study

Table 7 Risk of LLA in current GLP1-RA use compared to current SU use, stratified by cumulative dose and continuous duration of use

	Number of LLAs (N = 564)	IR (/1000 PY	Age/sex adjusted HR (95%CI)	Fully adjusted HR (95%CI)^a
Current SU use	54	2.14	Reference
Current GLP1-RA use	55	1.51	0.88 (0.60–1.29)	0.57 (0.39–0.84)
By cumulative dose
< 250 DDDs	15	1.48	0.92 (0.52–1.64)	0.65 (0.37–1.17)
250–1200 DDDs	20	1.09	0.64 (0.38–1.07)	0.42 (0.25–0.71)
≥ 1200 DDDs	20	2.54	1.36(0.81–2.29)	0.76 (0.45–1.30)
By continuous duration of use
1–160 days	21	2.26	1.42 (0.85–2.35)	0.95 (0.57–1.59)
161–365 days	11	1.37	0.81 (0.42–1.55)	0.53 (0.28–1.03)
> 365 days	23	1.27	0.71 (0.43–1.15)	0.44 (0.27–0.72)

The models have also been adjusted for current DPP4-I use (149 LLAs), current combined use (90 LLAs), current other NIGLD use (59 LLAs), current SGLT2-I use (36 LLAs) and past NIGLD use (121 LLAs) (not shown)
LLA lower limb amputation, IR incidence rate, PY person years, HR hazard ratio, CI confidence interval, NIGLD non-insulin glucose lowering drug, SU sulfonylurea, DPP4-I dipeptidyl peptidase-4 inhibitor, GLP1-RA glucagon-like peptide-1 receptor agonist, DDD daily defined dose
^aAdjusted for age; sex; diabetes duration; income category; immigrant status; education; history of diabetic foot ulcer, neuropathy, atherosclerosis, peripheral arterial disease, hypertension retinopathy, heart failure, hyperlipidaemia, ischaemic heart disease, osteomyelitis, renal disease, pulmonary heart disease, or bacterial foot infection; and the use of loop diuretics, antithrombotic agents, potassium sparing diuretics, lipid lowering drugs, angiotensin receptor blockers, digoxin, angiotensin converting enzyme inhibitors, or calcium channel blockers in the 6 months before the start of the exposure interval

ISSN: 1475-2840