Patients with diabetes are 10 times more likely to experience lower limb amputations than the general population and amputations have very significant morbidity, mortality, and financial implications. While common risk factors for amputation in patients with diabetes include poor glycemic control, diabetic peripheral neuropathy, or peripheral arterial disease, canagliflozin use was implicated in the CANVAS and CANVAS-R trials. However, the CANVAS Program trials were not specifically designed to evaluate the risk of lower-extremity amputations. Clearly, we need more information about the magnitude of risk when canagliflozin is used widely in a general population and who is at most risk.
Guest Authors: Julie Dally, PharmD, BCPS, BCACP and Amanda Schartel, PharmD, BCACP
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