Sodium-glucose cotransporter-2 (SGL-2) inhibitors are a class of prescription medications used with exercise and diet to lower blood sugar levels in adults with type-2 diabetes. These drugs have shown positive outcomes in recent times, but their adverse effects are not well-studies. This study aims to investigate the adverse events associated with the use of SGL-2 inhibitors.

This is a register-based cohort study that included a total of 17,213 new users of SGLT-2 inhibitors (dapagliflozin, 61%; empagliflozin, 38%; canagliflozin, 1%) and 17,213 users of glucagon-like peptide 1 (GLP1) receptor agonists (comparator). The primary outcome was serious adverse events, like lower-limb amputation, bone fracture, acute kidney injury, severe urinary tract infection, diabetic ketoacidosis, acute pancreatitis, and venous thromboembolism.

The findings suggested that the use of SGL-2 inhibitors was associated with an increased risk of lower limb amputation (IR 2.7 per 1,000 person-years) and diabetic ketoacidosis (1.3). However, other adverse events, including bone fracture (15.4), acute kidney injury (2.3), serious urinary tract infection (5.4), acute pancreatitis (1.3), and venous thromboembolism (4.2) did not show any significant associations. 

The research concluded that the use of SGLT-2 inhibitors was associated with an increased risk of limb amputation and diabetic ketoacidosis, but not with other adverse events.