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Metformin renal function — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin renal functionGPhC CRA

A person taking dapagliflozin is admitted for major surgery and will fast. Which perioperative medicine-safety action is required?

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

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Correct answer: D — Interrupt dapagliflozin and monitor blood ketones perioperatively

SGLT2 inhibitors should be interrupted in major surgery or acute serious illness because fasting and physiological stress increase ketoacidosis risk. Blood ketones, not urine glucose alone, should be monitored and treatment restarted only when the patient is stable and ketones are normal.

Reference: MHRA: SGLT2 inhibitors and diabetic ketoacidosis: https://www.gov.uk/drug-safety-update/sglt2-inhibitors-updated-advice-on-the-risk-of-diabetic-ketoacidosis