Liraglutide May Lower Risk for Foot Amputation in Type 2 Diabetes

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The use of liraglutide in patients with type 2 diabetes did not increase the risk for diabetes-related foot ulcers.
The use of liraglutide in patients with type 2 diabetes did not increase the risk for diabetes-related foot ulcers.

Patients with type 2 diabetes who took liraglutide were at a lower risk for foot amputation, according to a study recently published in Diabetes Care.

Researchers completed a post hoc analysis on data collected during the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial to determine the effect of liraglutide on rates of diabetes-related foot ulcers in patients who were also at high risk for cardiovascular events. Patients in the LEADER study were randomly assigned to either an intervention arm (n=4668), receiving 1.8 mg of liraglutide a day, or a control arm (n=4672), receiving a placebo. The study continued for 5 years with an average follow-up time of 3.8 years. A diabetes-related foot ulcer was specified as a medical event of special interest, and all complications related to the ulcer were documented.

Diabetes-related foot ulcers were more common in males, those with poor glycemic control, those who use insulin, and those who had diabetes for a longer period of time. Throughout the study, the liraglutide and placebo arms had comparable occurrences of foot infections (2.3% vs 2.8%, respectively), involvement of underlying structures (1.4% vs 1.7%, respectively), peripheral revascularization (0.4% vs 0.5%, respectively), and patients experiencing at least one diabetes-related foot ulcer (3.8% vs 4.1%, respectively). The researchers did find a significant difference in the reductions of ulcer-related foot amputations between the liraglutide and the placebo arm (HR 0.65, 95% CI, 0.45-0.95; P =.03). This decrease was even greater after the patient was on liraglutide for over a year (HR 0.55, 95% CI, 0.36, 0.84; P =.006).

Future studies need to address the actual mechanism behind the relationship between liraglutide and amputations, increase the follow-up time to assess long-term benefits, and reassess a potential link between the ulcer's underlying structure involvement and amputation.

In conclusion, liraglutide may help reduce the risk of ulcer-related foot amputation among patients with type 2 diabetes who are at risk for cardiovascular events, but this correlation needs further investigation.

This study was funded by Novo Nordisk. Please refer to reference for a complete list of authors' disclosures.

Reference

Dhatariya K, Bain SC, Buse JB, et al. The impact of liraglutide on diabetes-related foot ulceration and associated complications in patients with type 2 diabetes at high risk for cardiovascular events: results from the LEADER trial [published online August 2, 2018]. Diabetes Care. doi: 10.2337/dc18-1094

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