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Canagliflozin-associated Peripheral Vascular Ischemia: A Case Report
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| H. Hayder Ewad *1, A. Basheer2, S. Omairi3, M.S. Lafta2, M.G. Mahdi4 |
1- Department of Acute Medicine, College of Medicine, University of South Wales, Wales, UK
2- Department of Internal Medicine, Collage of Medicine, Wasit University, Kut, Iraq
3- Department of Anatomy and Biology, College of Medicine, Wasit University, Kut, Iraq
4- Department of Internal Medicine, College of Medicine, Baghdad University, Baghdad, Iraq |
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Abstract: (197 Views) |
Aims: Sodium-glucose transporter inhibitors 2 are a new drug group used for patients with diabetes mellitus. These are a very effective group in the management of type 2 diabetes, but side effects such as urinary tract infections and foot ulcers do appear, which is specific to canagliflozin. Therefore, the current case report focuses on patients taking canagliflozin who presented with foot and leg ulcers.
Patient & Methods: The patient was a 69-year-old man who went to the hospital after falling at home and was diagnosed with pneumonia and lower limb ulcers. The patient had a history of ischemic heart disease, chronic kidney disease, multiple sclerosis and type 2 diabetes mellitus (regarding canagliflozin). A complete laboratory examination was performed, and appropriate treatment was done, but unfortunately the patient died due to multiple comorbidities.
Findings: It seems that the risk of peripheral vascular ischemia is increased in type 2 diabetes patients taking canagliflozin. This case was mainly highlighted to confirm the fact that using canagliflozin is associated with increased incidence of lower limb amputation, particularly toes.
Conclusion: There may be is a relationship between canagliflozin and lower limb ulcers in patients with type 2 diabetes mellitus who are older than 65 years.
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| Keywords: Diabetes Mellitus [MeSH], Canagliflozin [MeSH], Ischemia [MeSH] |
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Full-Text [PDF 972 kb]
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Article Type: Case/Series Report |
Subject:
Veterans or Handicapped Health
Received: 2023/02/9 | Accepted: 2023/04/16 | Published: 2023/05/26
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| * Corresponding Author Address: Department of Acute Medicine, College of Medicine, University of South Wales, 8Forest Grove ,Treforest , Wales, UK. Postal Code: CF37 1DL (ssalman@uowasit.edu.iq) |
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| References |
1. Wilcox T, De Block C, Schwartzbard AZ, Newman JD. Diabetic agents, from metformin to SGLT2 inhibitors and GLP1 receptor agonists: JACC focus seminar. J Am Coll Cardiol. 2020;75(16):1956-74. [ Link] [ DOI:10.1016/j.jacc.2020.02.056] 2. Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Credence trial investigators canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019;380:2295-306. [ Link] [ DOI:10.1056/NEJMoa1811744] 3. Neal B, Perkovic V, Matthews DR, Mahaffey KW, de Zeeuw D, Fulcher G, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(21):2099. [ Link] [ DOI:10.1056/NEJMc1712572] 4. Heerspink H, Stefánsson BV, Correa Rotter R, Chertow GM, Greene T, Hou FF, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020;383(15):1436-46. [ Link] [ DOI:10.1056/NEJMoa2024816] 5. Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383(15):1413-24. [ Link] [ DOI:10.1056/NEJMoa2022190] 6. Cannon CP, Pratley R, Dagogo-Jack S, Mancuso J, Huyck S, Masiukiewicz U, et al. Cardiovascular outcomes with ertugliflozin in type 2 diabetes. N Engl J Med. 2020;383(15):1425-35. [ Link] [ DOI:10.1056/NEJMoa2004967] 7. Fralick M, Kim SC, Schneeweiss S, Everett BM, Glynn RJ, Patorno E. Risk of amputation with canagliflozin across categories of age and cardiovascular risk in three US nationwide databases: Cohort study. BMJ. 2020;370:m2812. [ Link] [ DOI:10.1136/bmj.m2812] 8. Ueda P, Svanström H, Melbye M, Melbye M, Eliasson B, Svensson A, et al. Sodium glucose cotransporter 2 inhibitors and risk of serious ad- verse events: nationwide register based cohort study. BMJ. 2018;363:k4365. [ Link] [ DOI:10.1136/bmj.k4365] 9. Wrobel JS, Mayfield JA, Reiber GE. Geographic variation of lower-extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care. 2001;24(5):860-4. [ Link] [ DOI:10.2337/diacare.24.5.860] 10. Canavan RJ, Unwin NC, Kelly WF, Connolly VM. Diabetes and nondiabetes-related lower extremity amputation incidence before and after the introduction of better organized diabetes foot care: Continuous longitudinal monitoring using a standard method. Diabetes Care 2008;31(3):459-63. [ Link] [ DOI:10.2337/dc07-1159] 11. Lytvyn Y, Bjornstad P, Udell JA, Lovshin JA, Cherney DZI. Sodium glucose cotransporter-2 inhibition in heart failure: Potential mechanisms, clinical applications, and summary of clinical trials. Circulation 2017;136(17):1643-58. [ Link] [ DOI:10.1161/CIRCULATIONAHA.117.030012] 12. Inzucchi SE, Iliev H, Pfarr E, Zinman B. Empagliflozin and assessment of lower-limb amputations in the EMPA-REG OUTCOME trial. Diabetes Care 2018;41(1):e4-5. [ Link] [ DOI:10.2337/dc17-1551] 13. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. EMPA-REG outcome investigators empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015;373:2117-28. [ Link] [ DOI:10.1056/NEJMoa1504720] |
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Hayder Ewad H, Basheer A, Omairi S, Lafta M, Mahdi M. Canagliflozin-associated Peripheral Vascular Ischemia: A Case Report. Iran J War Public Health 2023; 15 (2) :177-180 URL: http://ijwph.ir/article-1-1319-en.html
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