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DKA with SGLT2 inhibitor — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsDKA with SGLT2 inhibitorGPhC CRA

A patient taking empagliflozin reports nausea, abdominal pain and rapid breathing after a viral illness. Their home glucose is 10 mmol/L, so they think ketoacidosis is impossible. What is the most appropriate action?

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Correct answer: B — Arrange urgent assessment because ketoacidosis can occur with modest glucose

SGLT2 inhibitors can be associated with euglycaemic or modestly hyperglycaemic diabetic ketoacidosis. Symptoms such as nausea, abdominal pain and rapid breathing after illness require urgent assessment and ketone testing. Extra empagliflozin would worsen risk. Reassurance based only on glucose is unsafe.

Reference: BNF; MHRA Drug Safety Update