Potential application of mono-, dual-, and triple-target GLP-1 receptor agonists in improving the prognosis of patients with diabetic foot ulcers.

This review examines the potential role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in managing diabetic foot ulcers (DFUs), a serious chronic complication of diabetes associated with high rates of disability, recurrence, and mortality. The authors note that DFU-related mortality is strongly tied to cardiovascular events, suggesting that treatment should extend beyond local wound care to include cardiovascular risk reduction. The review systematically describes personalized application strategies for GLP-1 RAs based on DFU clinical staging, and compares mono-, dual-, and triple-target GLP-1 RA agents in terms of their clinical translational potential and adverse effect profiles specific to DFU patients. Notably, the authors highlight a key tension: while GLP-1 RAs have demonstrated cardiovascular protective effects in outcome trials, their appetite-suppressing and gastric-emptying-delaying properties may worsen malnutrition in DFU patients during acute infection phases. The review synthesizes existing evidence to propose more rational, stage-specific treatment frameworks. As a narrative review, it does not generate new primary data, and its conclusions are limited by the quality and scope of the underlying studies it synthesizes.

Why this grade: This is a narrative review synthesizing existing literature; it generates no new primary human or animal data, so its evidence grade reflects the review study type rather than direct experimental findings.