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SGLT2 inhibitor ketoacidosis — GPhC CRA MCQ

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ModerateAdverse Drug Reactions and Drug SafetySGLT2 inhibitor ketoacidosisGPhC CRA

A patient taking dapagliflozin has vomiting, abdominal pain and rapid breathing. His blood glucose is 9 mmol/L. He asks whether ketoacidosis is impossible because glucose is not very high. What is the most appropriate action?

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Correct answer: E — Refer urgently because euglycaemic ketoacidosis is possible

SGLT2 inhibitors are associated with diabetic ketoacidosis, which can occur with only modestly raised glucose. Vomiting, abdominal pain and rapid breathing are red flags requiring urgent assessment. The medicine may need to be withheld during acute illness according to clinical advice. Antacid supply would risk delaying care.

Reference: BNF; MHRA Drug Safety Update