SGLT-2 Inhibitor

Question 1

SGLT-2 monitoring prior to starting treatment?

Answer 1

Previous DKA
Unwell
Low carb diet.

Renal impairment

Question 2

Contraindication

Answer 2

Age over 85 - reduced volume

Severe hepatic impairment

Severe renal impairment

Question 3

Adverse effects

Answer 3

UTI, vulvovaginitis, balanoposthitis

Fournier’s gangrene

volume depletion

Question 4

Interaction - diuretics

Answer 4

Additive effect - increase risk of dehydration and hypotension

Question 5

Interaction - enzyme inducers (carbamazepine, st John wort, phenytoin)

Answer 5

Reduce efficacy

Question 6

Interaction - digoxin

Answer 6

Increase risk of digoxin toxicity.

Question 7

Action

Answer 7

Sodium glucose co-transporter inhibitor

Suppressed renal glucose reabsorption

Question 8

Hypoglycaemia riks

Answer 8

Unlikely to cause hypoglycaemia itself but may increase risk with other agents.

Question 9

Issue with renal function and SGLT-2 inhibitors

Answer 9

Action dependent on renal function

Increased incidence of renal adverse effects and adverse effects relating to volume depletion.

Question 10

Amputation risk

Answer 10

May increase amputation risk