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. 2026 May 29;123(11):297–301. doi: 10.3238/arztebl.m2026.0055

The Effects of New Antidiabetic Drugs on the Course of Peripheral Arterial Occlusive Disease

Knut Kröger 1,✉, Hinrich Böhner 2, Christian-Alexander Behrendt 3, Olga von Beckerath 1
PMCID: PMC13330741  PMID: 42059101

Summary

Background:

Peripheral arterial occlusive disease (PAOD) and diabetic foot syndrome (DFS) are the leading reasons for lower-limb amputation. The new antidiabetic drugs—GLP-1 receptor agonists (GLP-1-RA) and SGLT-2 inhibitors (SGLT-2-I)—improve glycemic control and lower the risk of cardiovascular events. The differing effects of these two drug classes on PAOD are currently under discussion.

Methods:

This narrative review is based on pertinent publications retrieved by a selective PubMed search employing the terms “peripheral arterial disease,” “SGLT-2 inhibitors,” and ‘GLP-1 receptor agonists.”

Results:

No randomized controlled trials (RCTs) of the use of SGLT-2 inhibitors and GLP-1 receptor agonists have yet been conducted in which amputation served as a primary endpoint; in the published trials, amputation is reported only as an adverse event. The SGLT-2 inhibitors empagliflozin and dapagliflozin, which are approved in Germany, were not associated with a significantly increased risk of amputation in RCTs. In one RCT, the GLP-1 receptor agonist semaglutide led to a median prolongation of maximum walking distance by 26.4 m in patients with PAOD. Evidence suggests that GLP-1 receptor agonists may improve the clinical course of PAOD.

Conclusion:

The available evidence concerning the effect of GLP-1 receptor agonists and SGLT-2 inhibitors on the course of peripheral arterial occlusive disease (PAOD) and diabetic foot syndrome is limited. At any rate, no evidence suggests that GLP-1-RAs or SGLT-2 inhibitors worsen the course of PAOD or increase the risk of amputation. In the authors’ judgment, the cardioprotective and nephro-protective effects of these drugs justify their use in patients with diabetic foot syndrome and PAOD.

Information on this CME.

This article has been certified by the North Rhine Academy for

Continuing Medical Education. The questions on this article may be found (in German) at http://daebl.de/RY95 (Deutsches Ärzteblatt’s CME portal).

Their English translation may be found in the PDF version of this article.

The closing date for entries is May 28, 2027. Participation is possible at cme.aerzteblatt.de

Peripheral arterial occlusive disease (PAOD) and diabetic foot syndrome (DFS) are the leading causes of major and minor lower-limb amputations (1, 2). Since diabetes mellitus is also a significant risk factor for atherosclerosis, the combination of diabetes mellitus and PAOD is common. The treatment of diabetes mellitus therefore plays a major role in the prevention of both DFS and peripheral atherosclerosis manifesting as PAOD. To improve the treatment of diabetes mellitus, new drugs have been developed that improve glycemic control. These include SGLT-2 inhibitors (SGLT-2, sodium-dependent glucose co-transporter 2) and GLP-1 receptor agonists (GLP-1-RA, glucagon-like peptide-1 receptor agonists).

SGLT-2 inhibitors (SGLT-2-I) specifically inhibit the renal sodium-dependent glucose transporter SGLT-2. This transport protein is located in the proximal renal tubule and is responsible for approximately 90% of glucose reabsorption (3, 4). This results in increased urinary glucose excretion with osmotic diuresis. Thus, SGLT-2 inhibitors act independently of insulin metabolism. In addition to this antidiabetic effect, SGLT-2 inhibitors also have positive effects on heart and kidney function and can be prescribed in chronic heart failure (5) and chronic kidney disease (6) even in the absence of overt diabetes mellitus. A meta-analysis of nine studies found that, in addition to the known effects on mortality and hospitalizations and independent of ejection fraction, the use of SGLT-2 inhibitors is also associated with improved maximal exercise capacity and quality of life (7). In Germany, however, only empagliflozin and dapagliflozin are approved.

GLP-1 receptor agonists are synthetically produced polypeptides that—like the natural peptide hormone GLP-1—bind to the GLP-1 receptor but have a longer halflife. They stimulate the secretion of insulin and inhibit the release of glucagon. They also delay gastric emptying and increase satiety (8, 9). Compared with other antidiabetic drugs, the risk of hypoglycemia is low. As a group, long-acting GLP-1-RAs in injectable and oral form reduce the frequency of cardiovascular endpoints, hospitalization for heart failure, renal events, and all-cause mortality in patients with type 2 diabetes (10). Regardless of these effects in individuals with type 2 diabetes, GLP-1-RAs currently rank among the most effective weight-loss drugs. For the treatment of obesity, higher doses are typically used than for the treatment of diabetes mellitus (11). In Germany, dulaglutide, exenatide, liraglutide, semaglutide, and tirzepatide are approved.

Based on the strong evidence regarding cardiovascular outcomes, the current S3 guideline on PAOD recommends the use of SGLT-2 inhibitors and GLP-1 receptor agonists after metformin in individuals with type 2 diabetes and PAOD as a useful adjunct to antidiabetic and cardiovascular therapy (12). These two drugs reduced cardiovascular mortality and morbidity in this high-risk population. The 2025 European Guidelines for Managing Lower Extremity Peripheral Arterial Disease published by the European Society of Vascular Medicine (ESVM) also favor these drugs (13).

On the other hand, there have been indications for several years that SGLT-2 inhibitors may have a negative interaction with PAOD. The studies analyzed to date have not permitted any definitive conclusions in this regard (14, 15). Nevertheless, the 2024 Intersocietal IWGDF, ESVS, SVS Guidelines on Peripheral Artery Disease in People with Diabetes and a Foot Ulcer (16) take an unfavorable view of SGLT-2 inhibitors. They state that these drugs should not be used in drug-naive individuals with a diabetes-related foot ulcer or gangrene and that, in individuals who are already receiving them, temporary treatment discontinuation should be considered until the affected foot has healed.

In light of the above, the aim of the present study is to review the literature on both classes of drugs specifically addressing the course of PAOD and to heighten awareness among physicians who primarily manage patients with PAOD.

Literature search

This narrative review is based on pertinent publications retrieved by a selective PubMed search employing the terms “peripheral arterial disease,” “SGLT-2 inhibitors,” and “GLP-1 receptor agonists.”

SGLT-2 inhibitors and amputation

A meta-analysis of randomized controlled trials on the association between SGLT-2 inhibitors and PAOD was published in 2024 (17). The authors analyzed the effects of SGLT-2 inhibitors on PAOD and the risk of amputation. They concluded that pharmacological treatment with SGLT-2 inhibitors for more than 100 weeks is associated with a significant increase in the risk of PAOD and amputation. This meta-analysis should be viewed critically, and this conclusion cannot be generalized in its current form since the study contains methodological flaws. A key factor in the results of the meta-analysis was the multiple inclusion of the CANVAS trial (18, 19). This introduces bias into the conclusions of the meta-analysis by Geng et al.

None of the other studies on SGLT-2 inhibitors have confirmed the results of the CANVAS trial. The CREDENCE study (CREDENCE, Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) investigated the effects of canagliflozin on renal function in patients with type 2 diabetes and albuminuric chronic kidney disease (20). Amputation rates did not differ between the canagliflozin group (12.3%; 70 of 2200) and the control group (11.2%; 63 of 2197).

The studies on SGLT-2 inhibitors approved for use in Germany also showed no increase in amputation rates. A study including a total of 8246 patients who received ertugliflozin investigated the effect on cardiovascular endpoints over a mean period of 3.5 years. Amputations were reported in only 0.6 per 100 patient-years in both the treatment and the control group (21). Studies with empagliflozin (22, 23) and dapagliflozin (24) in patients with heart failure also report no difference in amputation rates. In their study on empagliflozin in patients with chronic kidney disease, Herrington et al. reported an amputation rate of 0.8% in the empagliflozin group and 0.6% in the control group. This difference is not significant (25). Table 1 provides an overview of randomized controlled trials of SGLT-2 inhibitors approved for use in Germany that include amputation data. In contrast to the studies on GLP-1 receptor agonists discussed below, the studies on SGLT-2 inhibitors are all older. There are no recent studies on the effect of SGLT-2 inhibitors that focus on patients with PAOD or PAOD-relevant endpoints.

Table 1. Randomized controlled trials of SGLT-2 inhibitors reporting amputation data*.

Trial Drug SGLT-2 inhibitors Control Hazard ratio [95% CI]
n = Subgroup with PAOD (%)
A = Number of amputations (%)		 n = Subgroup with PAOD (%)
A = Number of amputations (%)
Cannon et al. 2020 (21) Ertugliflozin With 5 mg: n = 515 (18.7)
A = 54 (2.0)		 n = 512 (18.6)
A = 45 (1.6)		 n.a.
With 15 mg: n = 514 (18.7)
A = 57 (2.1)
Packer et al. 2020 (22) Empagliflozin n = n.a.
A = 13 (0.7)		 n = n.a.
A = 10 (0.5)		 n.a.
Anker et al. 2021 (23) Empagliflozin n = n.a.
n = 16 (0.5)		 n = n.a.
n = 23 (0.8)		 n.a.
Herrington et al. 2023 (25) Empagliflozin n = 224 (7)
A = 28 (0.8)		 n = 226 (7)
A = 19 (0.3)		 1.43 [0.80; 2.57]
Murray et al. 2019 (24) Dapagliflozin n = n.a.
A = 13 (0.5)		 n = n.a.
A = 12 (0.5)		 1.00
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*

The table reports the proportion of patients with PAOD at trial enrolment (where available from the publication) and the amputation rate over the course of the trial

n.a., not available; PAOD, peripheral arterial occlusive disease; SGLT-2-I, sodium-dependent glucose co-transporter 2 inhibitor; CI, confidence interval

GLP-1 agonists and amputation

In 2023, Liarakos et al. published a review article on the effect of GLP-1-RAs on cardiovascular outcomes in individuals with diabetes mellitus and PAOD (26). To this end, they analyzed randomized controlled trials, observational studies, and systematic reviews. They concluded that there is insufficient evidence on the effect of GLP-1-RAs on cardiovascular endpoints in patients with PAOD for reliable conclusions to be drawn. This has since changed.

A small randomized controlled trial involving 55 patients with type 2 diabetes and PAOD showed a significant increase in foot transcutaneous oxygen partial pressure (TCPO2) (27) and in 6-min walk distance following 6 months of treatment with liraglutide (mean ± standard deviation [SD]: 35.7 ± 5.8 m for the liraglutide group and 10.6 ± 5.5 m for the control group) (28). A US working group analyzed data from the TriNetX research network, which includes more than 1002 healthcare organizations (29). They used a 1: 1 propensity score-matched analysis to compare patients who had an ankle-brachial index (ABI) of 0.4-0.9 and received GLP-1-RAs with patients who did not receive this treatment. Major adverse limb events (MALEs) were defined as acute limb ischemia requiring either thrombectomy or major amputation. After matching for age, sex, diabetes status, smoking status, and coronary heart disease, two groups of 55 041 patients each were formed. Patients treated with GLP-1-RAs had a higher baseline weight (98 ± 25.8 kg compared with 85 ± 23.3 kg; p = 0.0001). At 1 year, there were fewer MALEs in the GLP-1-RA group (0.8% compared with 1.5%; p < 0.01), and this was significant in the multivariate analysis (hazard ratio [HR]: 0.57; 95% confidence interval: [0.51; 0.64]; p = 0.02). For example, there were significantly fewer below-the-knee amputations (0.23% compared with 0.33%; HR: 0.68 [0.54; 0.87]; p = 0.02), above-the-knee amputations (0.43% compared with 0.83%; HR: 0.53 [0.45; 0.62]; p = 0.01), and cases of acute limb ischemia (0.14% compared with 0.30 %; HR: 0.48 [0.36; 0.63]; p = 0.03) in the GLP-1-RA group. The authors concluded that the use of GLP-1-RAs in patients with moderate PAOD was associated with a lower rate of MALEs. Another retrospective cohort study using the TriNetX U.S. Collaborative Network investigated MALEs, defined as limb-threatening ischemia, revascularization procedures, or major amputation, over a follow-up period of 5 years. The use of GLP-1-RAs was associated with a lower risk of MALEs (HR: 0.22 [0.17; 0.28]; p < 0.001) (30).

The STRIDE study is a randomized, placebo-controlled, double-blind phase 3b trial to assess the use of 1 mg of subcutaneous semaglutide once weekly compared with placebo in individuals with symptomatic PAOD (Fontaine IIa claudication) and type 2 diabetes. The primary endpoint was the change in maximum walking distance on a constant load treadmill. In the 792 participants with diabetes mellitus for a median of 12.2 years, a hemoglobin A1c (HbA1c) level of 7.1%, and a body mass index (BMI) of 28.7 kg/m2, semaglutide improved the maximal walking distance (median 26.4 m [11.8; 40.9]) more than did placebo (31), and this effect was independent of diabetes duration, BMI, and HbA1c levels (32). The authors concluded that semaglutide improved walking capacity in individuals with PAOD and type 2 diabetes, including those without obesity and those with well-controlled HbA1c levels. The benefits were consistent across all BMI and HbA1c categories, confirming efficacy beyond weight or glycemic changes. Other post-hoc analyses from STRIDE showed that the consistent improvement in functional outcomes in individuals with early symptomatic PAOD and type 2 diabetes is regardless of sex (33) and also applies to smokers (34).

In 2025, a double-blind, placebo-controlled study on the cardiovascular safety of oral semaglutide was published (35). A total of 9650 participants with type 2 diabetes were included and followed-up for a mean period of 47.5 ± 10.9 months. Major adverse events affecting the limbs, defined as hospitalization due to acute or chronic limb ischemia, were observed in 71 (1.5%) participants in the semaglutide group and in 99 (2.1%) participants in the placebo group (HR 0.71 [0.52; 0.96]).

In 2026, a meta-analysis was published on the effect of GLP-1-RAs on cardiovascular and limb-related events in patients with type 2 diabetes and PAOD (36). The primary endpoints included all-cause mortality and cardiovascular mortality. Secondary endpoints comprised major adverse cardiovascular events (MACE), myocardial infarction, stroke, major adverse limb events (MALE), glycemic control, body weight, and adverse events. The pooled risk ratios and mean differences were calculated using random-effects models. Six randomized controlled trials with 7645 participants met the inclusion criteria. GLP-1-RAs significantly reduced all-cause mortality (relative risk [RR] 0.83 [0.70; 0.99], p = 0.04). Only two studies (32, 37) reported the effect on MALEs. This effect was almost identical in the treatment group (n = 1796, MALEs = 140 [7.8%]) and in the control group (n = 1796, MALEs = 161 [9.0%]) (HR 0.87 [0.70; 1.08]). Another meta-analysis of 10 studies reported that revascularization was required significantly less frequently in PAOD patients receiving GLP-1-RAs than in those who were not (odds ratio [OR] 0.85 [0.80: 0.90]; p < 0.001), and that, in patients with type 2 diabetes, the number of amputations (OR 0.58 [0.48; 0.69]; p < 0.001) was significantly lower than in the control group (38).

Table 2 lists randomized controlled trials on GLP-1-RAs that include statements on the course of PAOD and amputation.

Table 2. Randomized controlled trials of GLP-1-RAs reporting data on amputation and the course of PAOD*.

Trial Drug GLP-1-RAs Control Hazard ratio [95% CI]
n = Number with PAOD (%)
A = Number of amputations (%)		 n = Number with PAOD (%)
A = Number of amputations (%)
Badjatiya et al. 2019 (37) Exenatide n = 1400 (19.0)
A = 70 (5.0)		 n = 1400 (18.9)
A = 69 (4.9)		 0.99 [0.71; 1.38]
0.96 [0.66; 1.41]
n = Acute or chronic limb ischemia requiring hospitalization
M = number of MALEs (%)
Bonaca et al. 2025 (31) Semaglutide n = 396
M = 6 (1.5)		 n = 396
M = 5 (1.3)		 1.21 [0.36; 4.20]
n = Indicated peripheral revascularization per trial arm (%) For peripheral revascularization
Holman et al. 2017 (e5) Exenatide n = 117 (1.9) n = 157 (2.1) n.a.
Marso et al. 2016 (e6) Semaglutide n = 16 (1) n = 25 (1.5) 0.64 [0.34; 1.20]
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*

For ref. (37), the table reports the proportion of patients with PAOD at trial enrolment (where available from the publication) and the amputation rate over the course of the trial; for ref. (31), the occurrence of acute or chronic limb ischemia requiring hospitalization; and for refs. (e5, e6), the need for peripheral revascularization

GLP, glucagon-like peptide-1-receptor agonists; PAOD, peripheral arterial occlusive disease; MALE, major adverse limb events; n.a., not available; CI, confidence interval

Discussion

The new antidiabetic drugs, GLP-1-RAs and SGLT-2 inhibitors, improve diabetes control and reduce the risk of cardiac endpoints. However, there is debate as to whether the effect of these classes of drugs on the course of PAOD differs. GLP-1-RAs appear to improve peripheral arterial perfusion and lower amputation rates in patients with diabetes and PAOD. A retrospective cohort study using a nationwide electronic health database in the US to compare the effects of GLP-1-RAs and SGLT-2 inhibitors on vascular complications in patients with PAOD found that GLP-1-RAs were associated with a lower risk of major amputation (HR 0.79 [0.70; 0.90]), revascularization (HR 0.82 [0.76; 0.88]), and mortality (HR 0.71 [0.68; 0.73]) compared with SGLT-2 inhibitors (39). Another systematic meta-analysis concluded that GLP-1-RAs in patients with PAOD not only had positive effects on cardiovascular events and mortality but they also reduced the need for revascularization (38). A further meta-analysis concluded that the use of GLP-1-RAs is associated with a significant improvement in functional walking distance and a reduction in the risk of amputation in individuals with type 2 diabetes and PAOD (40).

There is no generally accepted explanation for the differing effects of these drug classes on peripheral arterial perfusion. For GLP-1-RAs, it has been demonstrated in vitro that they promote angiogenesis while simultaneously increasing vasodilatation through nitric oxide production (e1). The mode of action of SGLT-2 inhibitors is based on the urinary excretion of glucose. The associated osmotic diuresis results in volume depletion and hemodynamic instability. These factors can impair peripheral perfusion, thereby increasing the risk of ischemia and, as a result, of amputation (e2, e3). It therefore seems advisable to ensure adequate fluid intake, particularly in patients who develop diabetic foot syndrome while receiving such substances.

It should be noted, however, that there are no studies directly comparing GLP-1 RAs and SGLT-2 inhibitors in patients with PAOD or PAOD-related wounds using pain-free walking distance, the need for revascularization, or amputation as primary endpoints. It should also be noted that these studies on SGLT-2 inhibitors in which increased amputation rates were observed were not primarily designed to investigate the risk of amputation, and not all study results indicate the same trend. Moreover, there are no randomized controlled trials on SGLT-2 inhibitors that have evaluated the course of peripheral arterial occlusive disease as a primary endpoint. Added to this is the fact that the beneficial cardiovascular and renal effects are greater in magnitude than the effects on peripheral arterial perfusion (e4). Furthermore, individuals with foot wounds were often excluded from studies of SGLT-2 inhibitors.

A negative effect on the course of PAOD with increased amputation rates has not been demonstrated for either GLP-1-RAs or SGLT-2 inhibitors. The positive cardio- and nephroprotective effects of these drugs justify their use in patients with diabetic foot syndrome and PAOD. Although GLP-1 RAs have been shown overall to have a positive effect on the course of PAOD in people with diabetes—and semaglutide has specifically been shown in a randomized controlled trial to improve maximum walking distance in patients with diabetes and PAOD—there is currently no recommendation to use these agents primarily for this indication in this patient group.

Footnotes

Conflict of interest statement: CAB is Medical and Scientific Director of the Research Institute of the German Society for Vascular Surgery and Vascular Medicine (Deutsche Gesellschaft für Gefäßchirurgie und Gefäßmedizin), PAD Coordinator of the European Society for Vascular Surgery (ESVS), Co-Chair of the 2024 ESVS Clinical Practice Guidelines on Asymptomatic Peripheral Arterial Disease (PAD) and Intermittent Claudication, and Co-Chair of the 2027 Global Vascular Guidelines on the Management of Patients with Chronic LimbThreatening Ischaemia (CLTI).

The remaining authors declare that no conflict of interest exists.

Supplementary material

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Questions on the article in issue 11/2026: The Effects of New Antidiabetic Drugs on the Course of Peripheral Arterial Occlusive Disease

The submission deadline is 28.05.2027. Only one answer is possible per question.

Please select the answer that is most appropriate.

  • Question 1

    SGLT-2 inhibitors specifically inhibit the sodium-dependent glucose transporter SGLT-2.

    Where is this transporter primarily expressed?
    1. In the distal renal tubules
    2. In the endothelial cells of all arterioles
    3. In the collecting ducts of the kidney
    4. In the proximal renal tubules
    5. In the Bowman’s capsule of the nephrons

  • Question 2

    Which of the following effects is not among the modes of action of GLP-1 receptor agonists mentioned in the article?
    1. Stimulation of insulin secretion
    2. Inhibition of glucagon secretion
    3. Delayed gastric emptying
    4. Increased satiety
    5. Decreased leptin sensitivity

  • Question 3

    Which statement on the current state of knowledge of the effect of SGLT-2 inhibitors on PAOD and amputations is the most accurate?
    1. An increased amputation rate while using SGLT-2 inhibitors has not been observed as yet in any clinical trials.
    2. In all published studies on SGLT-2 inhibitors, amputation rates while using medication were significantly lower than in the control group.
    3. The majority of studies published to date showed a significant reduction in PAOD risk while using SGLT-2 inhibitors.
    4. Whereas the CANVAS trial showed an increased amputation rate while using SGLT-2 inhibitors, other randomized controlled trials of SGLT-2 inhibitors were unable to confirm this.
    5. There have been virtually no studies to date investigating amputation rates following the use of SGLT-2 inhibitors.

  • Question 4

    The article describes a propensity score-matched study with data from TriNetX on the effect of GLP-1 receptor agonists (GLP-1-RAs) on PAOD in individuals with diabetes.

    What conclusion can be drawn from the study?
    1. In patients with moderate PAOD, the use of GLP-1-RAs was not associated with clinically measurable benefits.
    2. In patients with moderate PAOD, the use of GLP-1-RAs was associated with a lower rate of major ischemic limb events.
    3. Among patients receiving GLP-1-RAs, a higher rate of major ischemic events was seen, but the minor amputation rate was significantly lower.
    4. The use of GLP-1-RAs in patients with moderate PAOD was associated with a worsening of the body mass index and a reduction in maximum walking distance.
    5. The rate of major ischemic events did not differ between patients receiving and patients not receiving GLP-1-RAs. However, a higher amputation rate was seen in the patient population receiving GLP-1-RAs.

  • Question 5

    Which drug was shown in a randomized, placebo-controlled, double-blind trial to improve maximum walking distance in individuals with symptomatic PAOD and type 2 diabetes?
    1. Glibenclamide
    2. Metformin
    3. Empagliflozin
    4. Semaglutide
    5. Dapagliflozin

  • Question 6

    Which limitation regarding the evidence is mentioned in the article?
    1. There are no studies directly comparing GLP-1-RAs and SGLT-2 inhibitors in patients with PAOD using pain-free walking distance, need for revascularization, or amputation as primary endpoints.
    2. None of the studies on the effect of GLP-1-RAs that also assessed the amputation rate had a control group.
    3. All randomized trials published to date on the effect of GLP-1-RAs in patients with PAOD were conducted with the drug semaglutide.
    4. In the studies on the effect of semaglutide on walking distance, only individuals with PAOD and obesity were included, meaning that no conclusions can be drawn regarding the effect on individuals without obesity.
    5. The randomized trials on the effect of GLP-1-RAs all had fewer than 100 participants and are therefore of little informative value.

  • Question 7

    Which effect of GLP-1-RAs has been demonstrated in vitro?
    1. Vasoconstriction in peripheral vessels through the release of endothelin
    2. Vasoconstriction in pericardial vessels through the release of vasopressin
    3. Promotion of angiogenesis and vasodilation through nitric oxide production
    4. Inhibition of insulin secretion through beta-cell blockade
    5. Promotion of platelet aggregation through thromboxane A2 activation

  • Question 8

    What does the abbreviation “MALE” stand for in the article?
    1. Minor adverse limb event
    2. Mild abnormal limb event
    3. Major amputation lower extremity
    4. Major adverse limb event
    5. Minor amputation lower extremity

  • Question 9

    According to the article, which recommendation is made in the S3 guideline on PAOD regarding

    the treatment of patients with type 2 diabetes and PAOD?
    1. Use of metformin alone is sufficient.
    2. GLP-1 receptor agonists and SGLT-2 inhibitors are recommended as a useful adjunct to antidiabetic and cardiovascular treatment.
    3. GLP-1 receptor agonists are only effective in obese patients with PAOD.
    4. There are no specific recommendations for the treatment of patients with PAOD and type 2 diabetes.
    5. SGLT-2 inhibitors should be avoided in all patients with PAOD and type 2 diabetes.

  • Question 10

    Which two diseases are named as the primary causes of major or minor lower limb amputations?
    1. Peripheral arterial occlusive disease and diabetic nephropathy
    2. Diabetic foot syndrome and coronary heart disease
    3. Chronic kidney disease and peripheral arterial occlusive disease
    4. Diabetic retinopathy and diabetic foot syndrome
    5. Peripheral arterial occlusive disease and diabetic foot syndrome

References (abbreviated)

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