Association of semaglutide with less limb events in people with type 2 diabetes and peripheral artery disease or foot ulcers: An observational study comparing matched cohorts.

AIMS: To compare major limb events in individuals with type 2 diabetes who initiated either injective or oral semaglutide versus other glucose-lowering therapies (GLT) in a real-world setting. MATERIALS AND METHODS: This was a single-centre retrospective observational study on new users of diabetes medications. Participants had to have type 2 diabetes and a diagnosis of peripheral artery disease (PAD) or foot ulcers. Participant characteristics were assessed before and after propensity score matching. The primary outcome was major limb events (a composite of peripheral percutaneous transluminal angioplasty [PTA] or critical limb ischaemia [CLI]); secondary outcomes included singularly PTA, CLI, gangrene and lower extremity amputation (LEA). RESULTS: We analysed two matched groups of 167 participants each, who were predominantly males (57%), aged 61 years, with a 12-year duration of diabetes, a baseline HbA1c of 8.0% and body mass index (BMI) of 31 kg/m. During a median follow-up of 30.1 months, a primary-outcome event occurred in 72 of the participants (43.0%; incidence, 8.1 events per 100 person-years) in the semaglutide group, as compared with 93 of the participants (56.0%; incidence, 10.4 events per 100 person-years) in the GLT group (hazard ratio [HR] = 0.77; 95% confidence interval [CI], 0.61-0.97; p = 0.029). Among the secondary outcomes, LEA (both major and minor) was 50% lower (HR = 0.50; 95% CI, 0.30-0.83, p = 0.008) in the semaglutide group as compared with the other group. CONCLUSIONS: Among people with type 2 diabetes and PAD or foot ulcers, the use of semaglutide was associated with a significantly lower risk of major limb events than other GLTs.