Optimizing risk management for post-amputation wound complications in diabetic patients: Focus on glycemic and immunosuppressive control

Table 2 Characteristics, advantages, disadvantages, and usage of common antidiabetic drugs

Drug name	Advantages	Disadvantages	Usage	Applicable patients and considerations
Metformin	Significantly lowers HbA1c levels; aids in weight reduction; reduces cardiovascular event risks	May cause gastrointestinal discomfort (e.g., diarrhea, nausea); use with caution in patients with renal impairment due to the risk of lactic acidosis	Typically taken orally, recommended during or after meals to reduce gastrointestinal side effects	Preferred for overweight or obese patients with type 2 diabetes, especially those at high risk of cardiovascular disease
Sulfonylureas	Rapidly lower blood glucose levels; convenient, often once-daily dosing	Risk of hypoglycemia; may cause weight gain	Usually taken before meals, with the dosage adjusted based on blood glucose levels	Suitable for patients without a high risk of hypoglycemia; attention needed for weight management in obese patients
DPP-4 inhibitors	Reduce HbA1c levels with minimal risk of hypoglycemia; minimal impact on weight	Relatively weaker glucose-lowering effect; potential risk of pancreatitis	Taken orally, typically once daily	Suitable for patients struggling with weight management or at risk of hypoglycemia, particularly elderly patients and those with chronic kidney disease
GLP-1 receptor agonists	Promote weight loss and improve cardiovascular health; significantly lower HbA1c levels	Require injection, which may reduce patient compliance; may cause gastrointestinal discomfort (e.g., nausea, vomiting)	Administered subcutaneously, usually weekly or daily depending on the drug type	Ideal for obese patients needing weight management and those with type 2 diabetes and cardiovascular diseases
Insulin	Effectively controls hyperglycemia and suitable for all types of diabetes; flexible dosage adjustments	Risk of hypoglycemia and weight gain; requires patient education and regular blood glucose monitoring	Administered subcutaneously, with dosage adjustments based on blood glucose levels and dietary intake	Suitable for patients with severe conditions or inadequate control with other medications, especially those with type 1 diabetes or gestational diabetes

HbA1c: Hemoglobin A1c.