UNASSIGNED: Sodium glucose cotransporter-2 inhibitors (SGLT2is) have gained immense attention for a variety of indications. Limb amputations (LA) and fractures were reported in clinical trials. This network meta-analysis and meta-regression were carried out to quantify the risks of these events.
UNASSIGNED: Randomized clinical trials evaluating SGLT2is and reporting patients developing LA/fracture were included. Odds ratios (OR) with 95% confidence intervals (95% CI) were the effect estimates. Sub-group analyses and meta-regression analysis were carried out.
UNASSIGNED: Ninety articles were included (LA: 36 studies; 96522 participants and fracture: 66 studies; 102,862 participants). An increased risk of LA (OR: 1.2; 95% CI: 1.1, 1.3) was observed. Amongst SGLT2is, canagliflozin was associated with increased risk of LA (OR: 1.6, 95% CI: 1.1, 2.4) while dapagliflozin with fracture (OR: 1.1, 95% CI: 1, 1.2). Sub-group analysis revealed increased risk of LA with an OR of 1.3 among those in the age group of > 40 to < 65, body-mass index of > 30 kg/m2, HbA1c category of > 7%, duration of diabetes of > 10 years, type 2 diabetes, and an OR of 1.2 for SGLT2is administration of > 6 months.
UNASSIGNED: SGLT2is were observed with an increased risk of LA. High- risk categories were identified for which precautions should be recommended in the standard treatment guidelines.
UNASSIGNED: Open Science Framework (https://osf.io/5fwyk).

暂无摘要。

Acromegaly per se predisposes to diabetes. Somatostatin analogs (SSAs) have an overall neutral effect on glycemic control. However, a marked increase in hyperglycemia was observed recently since the introduction of pasireotide long-acting release (PAS-LAR). Sodium glucose cotransporter inhibitors (SGLT2is) have proven their efficacy, cardiovascular safety, and superiority in the management of type 2 diabetes mellitus (T2DM). However, this class is rarely recommended for patients with diabetes and acromegaly. A decreased circulating insulin level is considered unique for this class and might have a beneficial role in the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis. Therefore, SGLT2is should be considered in the management of diabetes in patients with acromegaly. This article highlights the role of this novel class for the management of diabetes in patients with acromegaly.