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SGLT2 euglycaemic ketoacidosis — GPhC CRA MCQ

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ModerateAdverse Drug Reactions and Drug SafetySGLT2 euglycaemic ketoacidosisGPhC CRA

A patient taking empagliflozin feels nauseated, breathless and abdominally uncomfortable during a viral illness. Home glucose is 8mmol/L, so he thinks ketoacidosis is impossible. What monitoring is required?

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Correct answer: C — Refer urgently because ketoacidosis can occur with normal or moderately raised glucose

SGLT2 inhibitors can be associated with diabetic ketoacidosis that may occur with glucose levels lower than expected. Symptoms such as nausea, abdominal pain, and breathlessness during illness are concerning. Urgent assessment and ketone testing are needed.

Reference: BNF; MHRA