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SGLT2 inhibitor sick-day advice — GPhC CRA MCQ

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EasyEndocrine TherapeuticsSGLT2 inhibitor sick-day adviceGPhC CRA

A patient taking dapagliflozin for type 2 diabetes is vomiting and unable to keep fluids down. They ask whether to continue every tablet until their review in three days. What monitoring is required?

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

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Correct answer: A — Temporarily stop dapagliflozin and seek clinical advice about dehydration and ketoacidosis risk

SGLT2 inhibitors should usually be withheld during acute illness with vomiting, dehydration or reduced intake because of ketoacidosis and AKI risk. Patients should seek medical advice and follow their diabetes sick-day plan. Insulin should not be stopped without clinical advice, as this can precipitate ketoacidosis. NSAIDs can worsen renal risk during dehydration.

Reference: BNF; NICE CKS