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SGLT2 inhibitor adverse effect — SCE Endocrinology MCQ

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ModerateDiabetesSGLT2 inhibitor adverse effectSCE Endocrinology

A 42-year-old man with type 2 diabetes has recurrent genital candidiasis after starting dapagliflozin. HbA1c has improved from 82 to 61 mmol/mol and eGFR is 86 ml/min/1.73 m2. He is otherwise well. What is the most appropriate management?

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Correct answer: E — Treat candidiasis, reinforce hygiene advice and review SGLT2 tolerability

Genital mycotic infection is a recognised SGLT2 inhibitor adverse effect and is often managed with antifungal treatment and counselling, while reviewing ongoing tolerability. It does not require stopping metformin. Recurrent or severe infection may justify stopping the SGLT2 inhibitor, but the initial response is not cystoscopy.

Reference: BNF; NICE NG28