Ann Intern Med

SGLT-2i drugs linked to lower diabetic foot disease incidence than GLP-1 drugs

January 8, 2026

Diabetic foot disease diagnosis was lower in sodium–glucose cotransporter-2 inhibitor (SGLT-2i) users compared with glucagon-like peptide-1 receptor agonist (GLP-1 RA) users—largely due to lower neuropathy risk—in this registry cohort target trial emulation of patients with T2DM. Risks for foot ulcer, peripheral artery disease, and amputation were similar between the two drugs.

The Danish population-based study compared new users of SGLT-2is (N=53,769) to new users of GLP-1 RAs (N=30,380). Over 6 years’ follow-up, diabetic foot disease was noted in 10.8% of SGLT-2i users vs. 12.0% of GLP-1 RA users, for a risk ratio of 0.90 (95% confidence interval [CI], 0.84-0.97). However, differences emerged only after year 3, at which time 40% of SGLT-2i users and 32% of GLP-1 RA users had discontinued their initial treatment.

Source:

Kristensen FPB, et al. (2026, January 6). Ann Intern Med. Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists on Diabetic Foot Disease: An Emulated Target Trial. https://pubmed.ncbi.nlm.nih.gov/41490509/