GLP-1 agents and diabetic foot ulcers

NewsBot · Aug 6, 2018

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The Impact of Liraglutide on Diabetes-Related Foot Ulceration and Associated Complications in Patients With Type 2 Diabetes at High Risk for Cardiovascular Events: Results From the LEADER Trial.
Dhatariya K et al
Diabetes Care. 2018 Aug 2.

OBJECTIVE:
Diabetes-related foot ulcers (DFUs) and their sequelae result in large patient and societal burdens. Long-term data determining the efficacy of individual glucose-lowering agents on DFUs are lacking. Using existing data from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial, we conducted post hoc analyses assessing the impact of liraglutide versus placebo in people with type 2 diabetes and at high risk of cardiovascular (CV) events on the incidence of DFUs and their sequelae.

RESEARCH DESIGN AND METHODS:
The LEADER trial (NCT01179048) was a randomized, double-blind, multicenter, CV outcomes trial assessing liraglutide (1.8 mg/day) versus placebo, in addition to standard of care, for up to 5 years. Information on DFUs was collected systematically during the trial, and DFU complications were assessed post hoc through reviewing case narratives.

RESULTS:
During a median of 3.8 years' follow-up, similar proportions of patients reported at least one episode of DFU in the liraglutide and placebo groups (3.8% [176/4,668] versus 4.1% [191/4,672], respectively; hazard ratio [HR] 0.92, 95% CI 0.75, 1.13; P = 0.41). Analysis of DFU-related complications demonstrated a significant reduction in amputations with liraglutide versus placebo (HR 0.65, 95% CI 0.45, 0.95; P = 0.03). However, no differences were found for foot infections, involvement of underlying structures, or peripheral revascularization in the main analysis.

CONCLUSIONS:
Treatment with liraglutide in patients with type 2 diabetes and at high risk of CV events in the LEADER trial did not increase the risk of DFU events and was associated with a significantly lower risk of DFU-related amputations compared with placebo. This association, possibly due to chance, needs further investigation
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NewsBot · Mar 26, 2019

The use of this has just been granted a patent:
LIRAGLUTIDE IN DIABETIC FOOT ULCER

The present invention relates to the GLP - 1 receptor agonist liraglutide for use in medicine .
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NewsBot · Mar 26, 2024

Liraglutide for Lower Limb Perfusion in People With Type 2 Diabetes and Peripheral Artery Disease: The STARDUST Randomized Clinical Trial
Paola Caruso et al
JAMA Netw Open. 2024 Mar 4;7(3)

Importance: Peripheral artery disease (PAD) in diabetes may lead to diabetic foot ulcer and lower-extremities amputation. Glucagon-like peptide 1 receptor agonists have proven cardiovascular benefits in trials of people with type 2 diabetes at high cardiovascular risk.

Objective: To examine the effect of liraglutide on peripheral perfusion measured as peripheral transcutaneous oxygen pressure (TcPo2) in individuals with type 2 diabetes and PAD.

Design, setting, and participants: This open-label randomized clinical trial was conducted between February 1, 2021, and June 30, 2022, with a final follow-up on December 30, 2022, at University of Campania "Luigi Vanvitelli," Naples, Italy. Fifty-five individuals with type 2 diabetes, PAD, and TcPo2 between 30 and 49 mm Hg were included.

Interventions: Patients were randomized to receive 1.8 mg of subcutaneous liraglutide or conventional treatment of cardiovascular risk factors (control group) for 6 months.

Main outcomes and measures: Coprimary outcomes were the change from baseline of peripheral perfusion between groups and the comparison of the proportion of individuals who reached 10% increase of TcPo2 from baseline in each group.

Results: Fifty-five participants (mean [SD] age, 67.5 [8.5] years; 43 [78%] male) were randomized (27 to the liraglutide group and 28 to the control group) and analyzed. Participants had a median (IQR) hemoglobin A1c level of 6.9% (6.5%-7.8%) and a mean (SD) TcPo2 of 40.3 (5.7) mm Hg. Transcutaneous Po2 increased over time in both groups, with significant differences favoring the liraglutide group after 6 months (estimated treatment difference, 11.2 mm Hg; 95% CI, 8.0-14.5 mm Hg; P < .001). The 10% increase of TcPo2 occurred in 24 participants (89%) in the liraglutide group and 13 (46%) in the control group (relative risk, 1.91; 95% CI, 1.26-2.90; P < .001). Compared with the control group, individuals in the liraglutide group had a significant reduction of C-reactive protein (-0.4 mg/dL; 95% CI, -0.7 to -0.07 mg/dL; P = .02), urinary albumin to creatinine ratio (-119.4 mg/g; 95% CI, -195.0 to -43.8 mg/g; P = .003), and improvement of 6-minute walking distance (25.1 m; 95% CI, 21.8-28.3 m; P < .001).

Conclusions and relevance: In this randomized clinical trial of people with type 2 diabetes and PAD, liraglutide increased peripheral perfusion detected by TcPo2 measurement during 6 months of treatment. These results support the use of liraglutide to prevent the clinical progression of PAD in individuals with type 2 diabetes.
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NewsBot · May 24, 2025

The impact of semaglutide on wound healing in diabetes related foot ulcer patients: A TriNetX database study
Joshua E Lewis et al
Diab Vasc Dis Res. 2025 Mar-Apr;22(2):14791641251322909.

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, N = 6329) and non-users with DFU (Cohort B, N = 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%) (p < .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.
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NewsBot · Sep 2, 2025

Exploring the Role of GLP-1 Agents in Managing Diabetic Foot Ulcers: A Narrative and Systematic Review
Fiona S Gruzmark et al
Wound Repair Regen. 2025 Sep-Oct;33(5):e70085

Globally, there are 537 million people with diabetes, with an estimated 19%-344% of these people developing a diabetic foot ulcer, and 10% dying within a year of being diagnosed with a diabetic foot ulcer. Risk factors for developing a diabetic foot ulcer include age, sex, ethnicity, chronically elevated HbA1c, smoking history, cardiovascular disease, end-stage renal disease, and retinopathy. Diabetic foot ulcer recurrence rates are as high as 20%, and they have vast complications, including lower-extremity amputations. More recently, there has been a surge in the use of glucagon-like peptide 1 receptor agonists in managing diabetes and weight loss. The use of glucagon-like peptide 1 receptor agonists in treating diabetic foot ulcers in humans has not been extensively studied, but there are reports of using glucagon-like peptide 1 receptor agonists in other dermatologic diseases with positive outcomes, including androgenetic alopecia and hidradenitis suppurativa. This review aims to explore the potential of using systemic glucagon-like peptide 1 receptor agonists in managing diabetic foot ulcers, describing their effects on modulating wound repair, microvascular function, neuropathic symptoms, apoptosis, weight loss, oxidative stress, and inflammation. Additionally, a systematic review, following PRISMA guidelines, was conducted assessing the rate of diabetic foot complications in patients using glucagon-like peptide 1 receptor agonists when compared to a control group, with the results suggesting their potentially protective role. By managing multiple facets of diabetic foot ulcer pathophysiology, the use of glucagon-like peptide 1 receptor agonists may aid in their management and thus prevent recurrence.
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NewsBot · Mar 30, 2026

GLP-1 receptor agonist use and surgical outcomes following diabetic foot reconstruction: A propensity score-matched retrospective cohort study
Jared Z Zhang et al
J Plast Reconstr Aesthet Surg. 2026 Mar 6:116:6-12. doi: 10.1016/j.bjps.2026.03.001.

Background: This study aimed to evaluate the association between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and surgical outcomes, complications, and healthcare utilization in diabetic patients undergoing soft-tissue reconstruction for foot ulcers.

Methods: The TriNetX database was used to identify diabetic adult patients who underwent soft-tissue reconstruction for foot ulcers between January 2016 and February 2025. Cohorts were stratified by the history of GLP-1 RA use. A 1:1 propensity score matching was performed based on demographics, comorbidities, body mass index, and hemoglobin A1c. Risk ratios were compared for 90-day postoperative outcomes.

Results: After PSM, 1049 patients were included in each of the cohorts. GLP-1 RA users had lower 90-day rates of surgical-site infections (SSIs; 4.6% vs. 7.3%), revision surgery (3.7% vs. 6.3%), deep vein thrombosis (DVT; 2.1% vs. 5.0%), emergency department (ED) utilization (19.2% vs. 23.0%), and all-cause mortality (2.4% vs. 4.6%; all p<0.05) compared to nonusers. No significant differences were observed for wound dehiscence, pulmonary embolism, sepsis, and amputation rates (p>0.05).

Conclusion: GLP-1 RA use in diabetic patients undergoing soft-tissue reconstruction for foot ulcers was associated with lower rates of SSIs, surgical revisions, DVT, ED utilization, and all-cause mortality compared to nonusers. These findings suggest a potential protective role of GLP-1 RA in surgical recovery independent of metabolic effects. Prospective and experimental investigation is needed to clarify the mechanism and full impact of GLP-1 RA on surgical outcomes.
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GLP-1 agents and diabetic foot ulcers

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GLP-1 Receptor Agonists and Diabetic Foot Ulcers

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GLP-1 agents and diabetic foot ulcers

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GLP-1 Receptor Agonists and Diabetic Foot Ulcers

Regenerating agents (RGTAs)

Trail runners as agents of alien plant introduction into protected areas

Topical antimicrobial agents for treating foot ulcers in people with diabetes.

Naturally occurring wound healing agents

Federal agents raid Sandy Springs Podiatrist

Long term follow up of onychomycosis treated with systemic agents

Share This Page

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