Evidence map›Paper›PMID 40495570›Full record

ArticleDiabetes, obesity & metabolism2025

The use of SGLT2 inhibitors in people with diabetes-related foot disease: A Delphi-based consensus study.

Patrick Highton, Ruksar Abdala, Rachel Evley, Victoria Balasubramanian, Melanie Davies, Ketan Dhatariya, Frances Game, Clare Hambling, John R Petrie, Sam Seidu and 4 more

Abstract readConsensus Statement
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Implementing SGLT2 Inhibitor Therapy in Line with the New NICE Guidelines for Type 2 Diabetes Management.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Patrick HightonDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID 0000-0002-0410-5788
Ruksar AbdalaDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
Rachel EvleyNational Institute of Health and Care Research, Research Support Service Leicester Hub and Partners, University of Leicester, Leicester, UK.
Victoria BalasubramanianDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
Melanie DaviesDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID 0000-0002-9987-9371
Ketan DhatariyaElsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk, UK.
Frances GameDepartment of Research and Development, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
Clare HamblingNHS England, London, UK.
John R PetrieSchool of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.ORCID 0000-0002-4894-9819
Sam SeiduDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
Solomon TesfayeDiabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Jonathan ValabhjiDepartment of Metabolism, Digestion and Reproduction, Faculty of Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK.
David WebbDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID 0000-0002-3932-3339
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID 0000-0003-2343-7099

Funding

Diabetes UKNational Institute for Health and Care Research NIHR202021
6 · The paper itself

Abstract

aimsTo generate expert consensus-based clinical recommendations on the use of SGLT2 inhibitors in those with diabetes and diabetes-related foot disease (DFD). MATERIALS AND

methodsThis study employed a two-round online Delphi technique. Participants were healthcare practitioners from a range of relevant clinical backgrounds, recruited using convenience sampling. The statements for consideration were iteratively developed by study team members with expertise in managing diabetes and prescribing SGLT2 inhibitors, supported by key professional organisations and people with lived experience of DFD. Statements were ranked using a 6-point Likert Scale from Strongly Agree to Strongly Disagree. Consensus status for each statement was based on the Average Percent of Majority Opinions for each statement.

resultsTwenty-one participants completed round 1 of the survey, with 19 completing round 2. Participants represented a diverse range of healthcare professions, including Diabetologists, General Practitioners, Nurses and Pharmacists. Of the 25 total statements, 16 reached consensus (13 in round 1 and 3 in round 2), including: agreement on prescribing SGLT2 inhibitors to people with type 2 diabetes (regardless of ulceration status) with concurrent heart failure and/or chronic kidney disease; agreement that those with a previous healed ulcer or amputation should be prescribed SGLT2 inhibitors; disagreement that SGLT2 inhibitors per se increase amputation risk; agreement that canagliflozin should be avoided in this group.

conclusionsThese findings evidence the relative confidence of experienced clinicians in prescribing SGLT2 inhibitors to those with DFD, provided that they do not have a current ulcer and that canagliflozin is not prescribed.

Indexed as

Diabetes Mellitus, Type 2Diabetic FootSodium-Glucose Transporter 2 InhibitorsDelphi TechniqueFemaleHumansMaleMiddle AgedPractice Guidelines as TopicSodium-Glucose Transporter 2 Inhibitorsantidiabetic drugdiabetic neuropathySGLT2 inhibitortype 1 diabetestype 2 diabetes

Identifiers

PMID40495570
PMCPMC12232341

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.