Lewis Joshua E, Omenge Diana K, Patterson Amani R, Anwaegbu Ogechukwu, Tabukum Nangah N, Lewis Jimmie E, Lee Wei-Chen
John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Tilman J. Fertitta College of Medicine, University of Houston School of Medicine, Houston, TX, USA.
Diab Vasc Dis Res. 2025 Mar-Apr;22(2):14791641251322909. doi: 10.1177/14791641251322909. Epub 2025 Mar 13.
IntroductionDiabetes related foot ulcers (DFUs) are common complications of type 2 diabetes mellitus (T2DM), affecting 15-25% of individuals living with diabetes and significantly contributing to healthcare costs ($9-13 billion annually in the U.S.). Without effective management, these wounds often lead to severe outcomes like amputations. This study aims to examine the association of semaglutide on DFU management.MethodsThis retrospective cohort study utilized TriNetX US Research Network data to assess the impact of semaglutide, a GLP-1 receptor agonist, on DFU outcomes between 2013 and 2023. The study compared outcomes between semaglutide users with DFU (Cohort A, = 6329) and non-users with DFU (Cohort B, = 118,821) across 64 healthcare organizations. We matched participants by age, gender, race, and ethnicity; however, we excluded patients with certain co-morbidities. Statistical analysis, such as chi-square analysis and risk ratio, using TriNetX software evaluated different complication outcomes.ResultsSemaglutide users with DFU demonstrated lower relative risks for complications compared to non-users. Within 1 year, semaglutide users were associated with lower relative risks for wound healing complications (0.19% vs 0.38%), chronic non-healing wounds (0.75% vs 1.23%), chronic pain (4.44% vs 8.06%), wound care (2.42% vs 4.86%), wound dehiscence (0.26% vs 0.56%), and amputation (2.34% vs 5.21%) ( < .05). Similar trends persisted over 5 years. While these findings highlight potential benefits of semaglutide with patients with DFU, causation cannot be inferred due to the study's observational design.ConclusionSemaglutide use was associated with favorable outcomes in patients with diabetes-related foot ulcers, including reductions in wound-related complications. While these findings suggest potential benefits of semaglutide as an adjunct in DFU management, further research is needed to confirm these associations and to better understand the mechanisms involved.
引言
糖尿病相关足部溃疡(DFU)是2型糖尿病(T2DM)的常见并发症,影响15%至25%的糖尿病患者,且对医疗成本有显著影响(在美国每年达90亿至130亿美元)。若管理不当,这些伤口常导致截肢等严重后果。本研究旨在探讨司美格鲁肽与DFU管理之间的关联。
方法
这项回顾性队列研究利用TriNetX美国研究网络数据,评估2013年至2023年期间,胰高血糖素样肽-1(GLP-1)受体激动剂司美格鲁肽对DFU结局的影响。该研究比较了64家医疗机构中患有DFU的司美格鲁肽使用者(队列A,n = 6329)和未使用者(队列B,n = 118,821)的结局。我们按年龄、性别、种族和民族对参与者进行匹配;然而,我们排除了患有某些合并症的患者。使用TriNetX软件进行的统计分析,如卡方分析和风险比,评估了不同的并发症结局。
结果
与未使用者相比,患有DFU的司美格鲁肽使用者出现并发症的相对风险较低。在1年内,司美格鲁肽使用者出现伤口愈合并发症(0.19%对0.38%)、慢性不愈合伤口(0.75%对1.23%)、慢性疼痛(4.44%对8.06%)、伤口护理(2.42%对4.86%)、伤口裂开(0.26%对0.56%)和截肢(2.34%对5.21%)的相对风险较低(P <.05)。类似趋势在5年内持续存在。虽然这些发现凸显了司美格鲁肽对患有DFU患者的潜在益处,但由于该研究的观察性设计,无法推断因果关系。
结论
使用司美格鲁肽与糖尿病相关足部溃疡患者的良好结局相关,包括伤口相关并发症的减少。虽然这些发现表明司美格鲁肽作为DFU管理辅助药物的潜在益处,但需要进一步研究来证实这些关联,并更好地理解其中涉及的机制。