The use of SGLT2 inhibitors in people with diabetes‐related foot disease: A Delphi‐based consensus study (original) (raw)
Highton, P. et al. (2025) The use of SGLT2 inhibitors in people with diabetes‐related foot disease: A Delphi‐based consensus study.Diabetes, Obesity and Metabolism, 27(8), pp. 4537-4546. (doi: 10.1111/dom.16498) (PMID:40495570) (PMCID:PMC12232341)
Abstract
Aims: To generate expert consensus‐based clinical recommendations on the use of SGLT2 inhibitors in those with diabetes and diabetes‐related foot disease (DFD). Materials and Methods: This study employed a two‐round online Delphi technique. Participants were healthcare practitioners from a range of relevant clinical backgrounds, recruited using convenience sampling. The statements for consideration were iteratively developed by study team members with expertise in managing diabetes and prescribing SGLT2 inhibitors, supported by key professional organisations and people with lived experience of DFD. Statements were ranked using a 6‐point Likert Scale from Strongly Agree to Strongly Disagree. Consensus status for each statement was based on the Average Percent of Majority Opinions for each statement. Results: Twenty‐one participants completed round 1 of the survey, with 19 completing round 2. Participants represented a diverse range of healthcare professions, including Diabetologists, General Practitioners, Nurses and Pharmacists. Of the 25 total statements, 16 reached consensus (13 in round 1 and 3 in round 2), including: agreement on prescribing SGLT2 inhibitors to people with type 2 diabetes (regardless of ulceration status) with concurrent heart failure and/or chronic kidney disease; agreement that those with a previous healed ulcer or amputation should be prescribed SGLT2 inhibitors; disagreement that SGLT2 inhibitors per se increase amputation risk; agreement that canagliflozin should be avoided in this group. Conclusions: These findings evidence the relative confidence of experienced clinicians in prescribing SGLT2 inhibitors to those with DFD, provided that they do not have a current ulcer and that canagliflozin is not prescribed.
| Item Type: | Articles |
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| Additional Information: | This project is funded by the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research Programme and Diabetes UK (NIHR202021). The project was also supported by the NIHR Applied Research Collaboration East Midlands and the NIHR Leicester Biomedical ResearchCentre. Support was also received from the Association of BritishClinical Diabetologists and Primary Care Diabetes Society. PH is supported by an Advanced Research Fellowship award from the National Institute of Health and Care Research (NIHR303176). JV is supported by the NW London NIHR Applied Research Collaboration, the Imperial NIHR Biomedical Research Centre, and CW+ (the official charity of Chelsea and Westminster Hospital NHS Foundation Trust). |
| Keywords: | Diabetic neuropathy, antidiabetic drug, type 1 diabetes, SGLT2 inhibitor, type 2 diabetes. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Petrie, Professor John |
| Authors: | Highton, P., Abdala, R., Evley, R., Balasubramanian, V., Davies, M., Dhatariya, K., Game, F., Hambling, C., Petrie, J. R., Seidu, S., Tesfaye, S., Valabhji, J., Webb, D., and Khunti, K. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | Diabetes, Obesity and Metabolism |
| Publisher: | Wiley |
| ISSN: | 1462-8902 |
| ISSN (Online): | 1463-1326 |
| Published Online: | 11 June 2025 |
| Copyright Holders: | Copyright © 2025 The Author(s) |
| First Published: | First published in Diabetes, Obesity and Metabolism 27(8):4537-4546 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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Deposit and Record Details
| ID Code: | 357290 |
|---|---|
| Depositing User: | Publications Router |
| Datestamp: | 25 Jun 2025 11:06 |
| Last Modified: | 29 Jul 2025 14:24 |
| Date of acceptance: | 19 May 2025 |
| Date of first online publication: | 11 June 2025 |
| Date Deposited: | 25 June 2025 |
| Data Availability Statement: | Yes |