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Metformin sick day advice — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin sick day adviceGPhC CRA

A 56-year-old taking empagliflozin for type 2 diabetes has vomiting, abdominal pain and tachypnoea after a day of poor intake. Capillary glucose is 8.9 mmol/L and blood ketones are 3.2 mmol/L. What should the pharmacist advise?

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Correct answer: E — Omit empagliflozin and seek urgent medical assessment

SGLT2 inhibitors can cause diabetic ketoacidosis with only modest blood-glucose elevation. Vomiting, abdominal pain, tachypnoea and ketonaemia require urgent medical assessment, and empagliflozin should be withheld. A near-normal glucose value must not provide false reassurance or delay evaluation and treatment.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment