GLP-1 drugs linked to higher diabetic foot complications and increased hypotension risk

A retrospective analysis of over 1.2 million adults with type‑2 diabetes showed that use of GLP‑1 receptor agonists was associated with significantly lower rates of major diabetic foot complications—including osteomyelitis (RR 1.30), foot ulcers (RR 1.11) and lower‑extremity amputation (RR 1.24)—when compared with SGLT2 inhibitors. The researchers noted that “these findings underscore the multifactorial nature of diabetic foot disease” and emphasized the need for individualized therapy and foot‑surveillance in high‑risk patients.

Separate data presented at the ENDO 2026 meeting indicated that GLP‑1 agonist initiation in adults with pre‑existing hypertension led to a measurable rise in hypotensive events. Incidence increased from 8.7 % at baseline to 10.2 % at six months, and continued to climb to 18.1 % at 24 months, with the greatest frequency in patients aged ≥65 years. About one‑quarter of patients had reductions in antihypertensive medication dosage. The authors concluded that “GLP‑1 RA usage is associated with a measurable and clinically significant increase in hypotensive‑related events” and called for further risk‑stratification studies.