A consensus study has found “relative confidence” of clinicians in prescribing SGLT2 inhibitors to those with diabetes-related foot disease, provided that patients do not have a current ulcer and that canagliflozin is not prescribed.
The study team, which included researchers from the Diabetes Research Centre in Leicester, set out to generate expert consensus-based clinical recommendations on the use of SGLT2 inhibitors in those with diabetes and diabetes-related foot disease (DFD).
Using a two-round online Delphi technique, participants were healthcare practitioners from a range of relevant clinical backgrounds and included diabetologists, GPs, nurses and pharmacists.
Statements were ranked using a 6-point scale from Strongly Agree to Strongly Disagree, with 21 participants completing round 1 of the survey and 19 completing round 2.
Of the 25 total statements, 16 reached consensus 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.
