Good question. But we don’t know the answer yet.
European authorities and even the U.S. Food and Drug Administration are looking into the possible connection. Stay tuned. Visit The Low Carb Diabetic site (link below) for more details.
“The European Medicines Agency (EMA)’s Pharmacovigilance Risk Assessment Committee (PRAC) has extended the scope of its investigation into the possible link between the sodium glucose cotransporter 2 (SGLT2) inhibitor canagliflozin (Invokana, Vokanamet, Janssen) and amputations to include other drugs of the same class.
Now, the PRAC’s review will include the other SGLT2 inhibitor medicines dapagliflozin (Farxiga, Xigduo XR, AstraZeneca), and empagliflozin (Jardiance, Boehringer Ingelheim), based on the determination that the potential risk may be relevant for them as well.”
Source: The Low Carb Diabetic: EMA Extends Amputation Investigation to All SGLT2 Inhibitors
Steve Parker, M.D.
PS: SGLT2 inhibitors are the drugs that reduce blood glucose by shunting it into your urine. Makes more sense to me instead to reduce your blood sugar by eating fewer carbohydrates, the primary source of blood sugar in most folks.
Which is great news from DiabetesHealth. I have noticed this in my own practice. One potential contributor to lower amputations not mentioned in the article is improved blood flow through angioplasty and other high-tech options.
A quote from DiabetesHealth:
According to Dr. Bill Releford, founder of the Releford Foot & Ankle Institute in Beverly Hills, as many as 75 percent of all amputations are preventable. He offered the following tips in a recent press release:
* Do not smoke.
* Exercise daily
* Control your cholesterol.
* Dry in between all toes after bathing.
* Always control your diabetes and blood pressure.
* Always wear shoes made from natural sources such as calfskin or soft leathers.
* Never pull or pick skin from your feet.
* Eat at least five colors of fruits and vegetables every day.
* Never cut toenails or trim calluses if you have diabetes or poor circulation. See a podiatrist for routine foot care.
* Never go barefoot if you have diabetes,even at home.
Also important is to inspect your feet for problems daily, or have someone do it for you. See your doctor or podiatrist if something doesn’t look right.
Here’s a quote from a recent Diabetes Care:
Improved therapeutics and health care delivery have brought remarkable declines in the incidence of … complications, with a 50% reduction in amputations from their peak in 1997 and ∼35% reduction in the incidence of end-stage renal disease. Similarly, 10-year coronary heart disease risk dropped from 21% in 2000 to 16% in 2008.
Nevertheless, diabetes remains the leading cause of blindness, renal failure, nontraumatic lower-limb amputation, in adults 18 to 65 years of age. We gotta stay after it!
The essay by Dr. Robert Ratner also notes 79 million Americans with prediabetes. They need my Conquer Diabetes and Prediabetes book. It’s only $9.99 (USD), a drop in the ocean compared to the $174 billion spent on diabetes in 2007 in the U.S.