ArticleCardiovascular diabetology2021
SGLT2 inhibitors and lower limb complications: the diuretic-induced hypovolemia hypothesis.
Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Association between sodium-glucose cotransporter-2 inhibitor and adverse events in patients with moderate to severe chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials.European journal of clinical pharmacology · 2025Pooled it
- Heart failure, peripheral artery disease, and dapagliflozin: a patient-level meta-analysis of DAPA-HF and DELIVER.European heart journal · 2023Pooled it
- Toxicological profile of anti-diabetic drugs and emerging measures to reduce the toxic burden.Toxicology reports · 2026Review
- Differential Effect of GLP-1 Receptor Agonists and SGLT2 Inhibitors on Lower-Extremity Amputation Outcomes in Type 2 Diabetes: A Nationwide Retrospective Cohort Study.Diabetes care · 2025Article
- SGLT2 Inhibitors and GLP-1 Receptor Agonists in PAD: A State-of-the-Art Review.Journal of clinical medicine · 2025Review
- SGLT2 Inhibitors: From Structure-Effect Relationship to Pharmacological Response.International journal of molecular sciences · 2025Review
- Unravelling the cardio-renal-metabolic-foot connection in people with diabetes-related foot ulceration: a narrative review.Cardiovascular diabetology · 2024Review
- Novel antidiabetic therapies in patients with peripheral artery disease: current perspective.Frontiers in clinical diabetes and healthcare · 2024Article
- Drug Safety Evaluation of Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Comorbid Patients by Review of Systemic Extraglycemic Effects.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Review
- Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Review
- A study on the pharmacovigilance of various SGLT-2 inhibitors.Frontiers in medicine · 2024Article
- Sodium-glucose co-transporter 2 inhibitor use in patients with diabetes mellitus undergoing endovascular therapy for symptomatic peripheral artery disease.Cardiovascular diabetology · 2023Article
- Optimal use of SGLT2 inhibitors in diabetic kidney transplant recipients.Frontiers in nephrology · 2022Review
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.