Diabetic foot ulcer (DFU) is a major cause of nontraumatic lower-limb amputation (LLA). The safety of sodium–glucose cotransporter 2 inhibitors (SGLT2 inhibitors) in this setting remains uncertain, especially in patients with active ulcers. Data specific to this population have been limited.

A retrospective, single-center study published in Diabetes Care assessed outcomes in patients treated for a new DFU between January 2022 and May 2024. The analysis included 452 patients with 1 year of follow-up. Among them, 94 received SGLT2 inhibitors, and 358 did not. The mean age was 70.2 ± 11.6 years, and 77% were men. The primary endpoint was the 1-year amputation rate.

The analysis showed no association between SGLT2 inhibitor use and the 1-year amputation rate (P=0.688). The proportion of ulcers healed at 6 months did not differ significantly between groups (54.4% vs 44.5%; P=0.091). The mean time to healing was shorter in the SGLT2 inhibitor group by 44 days (136.5 ± 97.8 vs 181.2 ± 159.8 days; P=0.04). The 1-year mortality rate was lower in patients who received SGLT2 inhibitors (1.1% vs 9.2%; P=0.009).

These findings show no difference in amputation or healing rates with SGLT2 inhibitor use in patients with DFU, with shorter healing time and lower mortality observed at 1 year.