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These CVOT findings are supported by a real-world study performed in over 3 million patients with T2DM from the United States, in which patients treated with SGLT2is did not have a higher risk of any or lower amputation compared with incretins or other glucose-lowering agents [77]
van Eyk HJ, Paiman EHM, Bizino MB SLIJ, et al

It can also be a sign of other underlying issues that need to be addressed

These are voluntary reports, not controlled study results