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SGLT2 inhibitor ketoacidosis — GPhC CRA MCQ

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HardEndocrine TherapeuticsSGLT2 inhibitor ketoacidosisGPhC CRA

A 48-year-old man taking empagliflozin for type 2 diabetes asks for advice after two days of vomiting and abdominal pain. His glucose is 9.8mmol/L, he is breathing faster than usual and has ketone test strips at home. What would you advise the patient?

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Correct answer: E — Stop empagliflozin temporarily and seek urgent assessment for ketoacidosis

SGLT2 inhibitors can cause diabetic ketoacidosis, sometimes with relatively modest glucose concentrations. Vomiting, abdominal pain and tachypnoea are concerning symptoms and require urgent assessment. Sick-day advice generally includes withholding the SGLT2 inhibitor during acute illness and maintaining hydration. Extra doses would increase risk and delay appropriate care.

Reference: BNF; MHRA Drug Safety Update