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If fatigue persists despite these interventions, or if it is accompanied by other concerning symptoms, further medical evaluation is warranted to exclude alternative diagnoses

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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]

doi: 10.1056/NEJMoa1901118 55 RosenstockJAllisonDBirkenfeldALBlicherTMDeenadayalanSJacobsenJBet al