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Diabetic kidney disease — UKMLA MCQ

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HardRenalDiabetic kidney diseaseUKMLAMRCGP AKTPARAMRCP Part 1PSA

A patient taking an SGLT2 inhibitor develops vomiting and an acute febrile illness with reduced intake. What medicine-safety action is appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Temporarily interrupt the SGLT2 inhibitor and assess for ketosis

The best answer is “Temporarily interrupt the SGLT2 inhibitor and assess for ketosis”. Acute illness, fasting and dehydration increase SGLT2-associated ketoacidosis risk, which can occur with near-normal glucose. The medicine is interrupted, hydration and ketones are assessed, and urgent care is arranged when DKA is suspected. Restart follows clinical recovery and review of the precipitant.

Reference: MHRA: SGLT2 inhibitors and diabetic ketoacidosis: https://www.gov.uk/drug-safety-update/sglt2-inhibitors-canagliflozin-dapagliflozin-empagliflozin-risk-of-diabetic-ketoacidosis