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GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study
Bonnet JB, Huguet H, Avignon A, Duflos C, Sultan A.. Diabetes care, 2026-05-01
Topic: Brain proteins, microglia and lab models
Objective This nationwide study aimed to identify factors associated with 1-year mortality following a first diabetic foot ulcer (DFU) using the French National Health Data System (SNDS). A secondary objective was to analyze mortality after major lower-limb amputation within the same time frame. Research design and methods A retrospective cohort analysis was conducted using SNDS data to identify adults with incident DFUs between January 2017 and December 2018, with 12 months of follow-up. Inclusion criteria combined hospitalization records and community care data. Cox proportional hazards models were used to estimate associations with mortality, adjusting for demographic, clinical, treatment, and care access variables. Results Among 133,791 individuals with incident DFU, 14.6% died within 1 year, and 3.5% underwent a major amputation. Of those amputated, 28.8% died within a year. Independent predictors of 1-year mortality included male sex, older age, hospital-acquired DFU, insulin, major amputation, cardiovascular disease, cancer, dementia, ESKD, and liver disease. Protective factors included lipid-lowering therapy, glucagon-like peptide 1 (GLP-1) receptor agonists, and prior consultations with diabetologists, ophthalmologists, and podiatrists. Similar patterns were observed for postamputation mortality, with GLP-1 receptor agonists showing a consistent survival benefit. Conclusions One-year mortality after DFU remains high and is strongly linked to age and comorbidities. Community-based identification highlights the vulnerability of these patients, even outside hospital settings. Glucagon-like peptide 1 receptor agonists and structured, multidisciplinary follow-up are associated with better survival and should be prioritized. These findings underline the urgent need to reinforce preventive care and optimize care pathways for high-risk diabetic populations.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Bonnet, J. B., Huguet, H., Avignon, A., Duflos, C., & Sultan, A. (2026). GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study. Diabetes care. https://doi.org/10.2337/dc25-2120
Vancouver
Bonnet JB, Huguet H, Avignon A, Duflos C, Sultan A. GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study. Diabetes care. 2026. doi:10.2337/dc25-2120. PMID: 41615296.
BibTeX
@article{bonnet2026-41615296,
author = {Bonnet, J. B. and Huguet, H. and Avignon, A. and Duflos, C. and Sultan, A.},
title = {{GLP-1 Receptor Agonists Are Associated With Reduced Mortality Following Diabetic Foot Ulcers: A Nationwide Observational Study}},
journal = {Diabetes care},
year = {2026},
doi = {10.2337/dc25-2120},
pmid = {41615296},
url = {https://doi.org/10.2337/dc25-2120}
}
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Key findings
- Objective This nationwide study aimed to identify factors associated with 1-year mortality following a first diabetic foot ulcer (DFU) using the French National Health Data System (SNDS).
- Results Among 133,791 individuals with incident DFU, 14.6% died within 1 year, and 3.5% underwent a major amputation.
- Glucagon-like peptide 1 receptor agonists and structured, multidisciplinary follow-up are associated with better survival and should be prioritized.
- These findings underline the urgent need to reinforce preventive care and optimize care pathways for high-risk diabetic populations.
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Study details
- Study designretrospective cohort
- Participants133,791
- Effect size14.6%; 3.5%; 28.8%
- Evidence strengthModerate
How this study scored 78/100
Published in a leading specialty journal, and it is a retrospective cohort study, reconstructed from past records. Scored zero for randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 45 of the 58 points we could judge it on, which is 78 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Diabetes care) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 4 / 4 | 133,791 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41615296) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 45 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 45 of the 58 points we could judge it on is 78 out of 100. |
| Total | 78 / 100 | — |
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