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SGLT2 inhibitor ketoacidosis — GPhC CRA MCQ

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HardEndocrine TherapeuticsSGLT2 inhibitor ketoacidosisGPhC CRA

A 61-year-old man with type 2 diabetes takes dapagliflozin. He phones because he has abdominal pain, vomiting and rapid breathing, but his glucose reading is 9mmol/L. He has eaten little for two days. What is the most appropriate action?

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

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Correct answer: A — Refer urgently for possible ketoacidosis despite modest glucose

SGLT2 inhibitors can be associated with diabetic ketoacidosis, including euglycaemic presentations where glucose is not markedly raised. Vomiting, abdominal pain and rapid breathing are red flags. The patient requires urgent assessment and ketone testing, and the SGLT2 inhibitor is usually withheld during acute illness.

Reference: BNF; MHRA Drug Safety Update