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SGLT2 inhibitor sick day advice — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsSGLT2 inhibitor sick day adviceGPhC CRA

A 58-year-old woman taking empagliflozin for type 2 diabetes phones with vomiting and reduced oral intake for 24 hours. Her blood glucose is 9 mmol/L. She asks whether to continue all her medicines. What would you advise the patient?

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

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Correct answer: D — Temporarily stop empagliflozin and seek medical advice if ketone symptoms or dehydration occur

SGLT2 inhibitors should usually be paused during acute illness with vomiting, dehydration or reduced intake because of ketoacidosis risk. Euglycaemic ketoacidosis can occur even when glucose is not very high. The patient should receive sick day advice and seek urgent help if symptoms such as abdominal pain, rapid breathing or drowsiness occur.

Reference: BNF; NICE CKS