Update on SGLT2 inhibitors for people with diabetes
What are SGLT2 inhibitors?
Sodium-Glucose Co-transporter-2 (SGLT2) inhibitors are a type of diabetes medication. The medicine works in the kidneys so that excess glucose comes out in your urine.
They can be prescribed on their own or in a combination tablet for diabetes including:
- Dapagliflozin - Forxiga, Xigduo, Qtern
- Empagliflozin - Jardiance, Jardiamet, Glyxambi
- Ertugliflozin - Steglatro, Segluromet, Steglujan
What are the benefits and side effects of taking SGLT2 inhibitors?
The benefits of SGLT2 inhibitors include:
- Lower blood glucose level
- Weight loss
- Better blood pressure
- Lower risk of death in people with heart disease
Possible side effects of SGLT2 inhibitors include:
- Genital or urinary tract infections
- Passing more urine more often; being thirstier
- Nausea and constipation
- Low blood pressure and dehydration
- Diabetic ketoacidosis (see below)
What is diabetic ketoacidosis (DKA)
DKA happens when the body doesn’t have enough insulin and acid levels in the blood become too high. DKA is rare, but serious, and needs urgent medical treatment.
It is most likely to happen at the time of surgery, severe infection or illness.
What are the symptoms of DKA?
Symptoms of DKA include:
- nausea and vomiting
- abdominal pain
- rapid breathing
If you experience any of these symptoms you should:
- Go to the nearest hospital Emergency Department.
- Tell the emergency doctor that you are taking this medicine
How can I reduce the risk of DKA?
To reduce the chance of DKA, stop taking your SGLT2 inhibitor:
- At least three days before fasting for surgery or a procedure
- If you are unable to eat or drink e.g. nausea, vomiting
- If you are unwell with an infection or illness
- If you are on a very low carbohydrate diet
- Anytime you see a doctor you need to tell them that you are taking an SGLT2 inhibitor
- If you are unwell then ask the doctor to test your blood glucose and ketone levels
- Check with a doctor before you start taking your SGLT2 inhibitor again.