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SGLT2 inhibitor ketoacidosis — GPhC CRA MCQ

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HardEndocrine TherapeuticsSGLT2 inhibitor ketoacidosisGPhC CRA

A 59-year-old woman taking empagliflozin 10 mg daily develops vomiting, abdominal pain and malaise during a low-carbohydrate diet. Her glucose is 9.8 mmol/L and urine ketones are positive. What is the most appropriate action?

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Correct answer: B — Stop empagliflozin temporarily and arrange urgent assessment for ketoacidosis

SGLT2 inhibitors can cause diabetic ketoacidosis with normal or mildly raised glucose. Vomiting, abdominal pain and ketones are red flags requiring urgent assessment. The medicine should be withheld during acute illness and the patient needs sick-day counselling after recovery.

Reference: BNF; MHRA Drug Safety Update