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Peri-operative diabetes — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateDiabetesPeri-operative diabetesSCE Endocrinology

A 67-year-old man with type 2 diabetes on metformin and empagliflozin is admitted for elective hemicolectomy. He is fasting from midnight and has an enhanced recovery plan. What is the most appropriate peri-operative diabetes medication advice?

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

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Correct answer: E — Withhold the SGLT2 inhibitor before surgery and monitor ketones if unwell

SGLT2 inhibitors should be withheld around surgery because of euglycaemic DKA risk. Continuing them through fasting and surgical stress is unsafe. The pearl is that ketone monitoring can be needed even when glucose is not markedly elevated.

Reference: JBDS Peri-operative Diabetes Guideline; BNF