Which antidiabetic drug carries a risk of lower limb amputation, prompting heightened foot care and hydration advice?

• A. Empagliflozin
• B. Dapagliflozin
• C. Canagliflozin
• D. Metformin

Answer: (C)

Some antidiabetic medicines carry safety signals that affect the feet and circulation. Among the SGLT2 inhibitors, one drug has shown an increased risk of lower-limb amputation in clinical studies. This is why patients starting this therapy are given heightened foot care and hydration advice. Canagliflozin has been associated with higher amputation risk in trials, so clinicians emphasize daily foot inspections, proper footwear, prompt care for wounds or ulcers, and maintaining good hydration to reduce dehydration and ensure adequate tissue perfusion. The other SGLT2 inhibitors, such as empagliflozin and dapagliflozin, do not show the same consistent amputation signal, and metformin does not carry this risk.