skip to main content

SGLT2 inhibitor risk in type 1 diabetes — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardDiabetes mellitusSGLT2 inhibitor risk in type 1 diabetesSCE Endocrinology

A 28-year-old woman with type 1 diabetes has recurrent vulvovaginal candidiasis and asks to start an SGLT2 inhibitor because her friend lost weight on it. HbA1c is 72 mmol/mol and she has had DKA twice in 2 years. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: B — Decline SGLT2 inhibitor initiation and optimise type 1 diabetes therapy and education

Decline SGLT2 inhibitor initiation and optimise type 1 diabetes therapy and education is best because recurrent DKA and genital infections identify a high-harm phenotype, and insulin remains essential in type 1 diabetes. The alternatives are less appropriate because weight benefit does not outweigh ketoacidosis risk; metformin cannot replace insulin; gliclazide is inappropriate; sick-day SGLT2 use is unsafe. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG17; MHRA SGLT2 safety advice