Patient Information Leaflet: SGLT2 Inhibitors and Diabetic Ketoacidosis in Type 2 Diabetes
Why have I been given this leaflet?
You are taking or about to start taking one of the following drugs:
- Canagliflozin (Invokana)
- Dapagliflozin (Forxiga)
- Empagliflozin (Jardiance)
There has been new information about these drugs which you should know about.
Taking an SGLT2
How does this tablet work?
It reduced your blood glucose by encouraging your kidneys to pass it into your urine, so your urine will contain glucose. This can increase the risk of Urinary Tract Infections and thrush.
Advice when taking these tablets
Drink plenty of fluids ideally up to 2 litres aper day as you pass more urine than usual.
Ensure good hygiene to reduce the risk of infection.
If you have thrush or urine infections seek medical advice and treatment. If this happens again it may be stopped.
It is really important that if you are unwell and not able to drink enough fluids or if you have diarrhoea or vomiting, you stop taking this tablet. If you are also taking Metformin to help manage your diabetes, stop this too until you return to eating and drinking as normal.
What can be a problem when taking these tablets?
People taking this drug can develop an unusual complication of diabetes that can lead to too much acid in your blood. This is called diabetic ketoacidosis and can happen even when your blood glucose levels are normal. If not recognised early this can be a dangerous situation but it is very rare.
What should I look out for?
If you are taking one of these tablets, please look out for these symptoms: nausea, vomiting, fast breathing, abdominal pains or fever.
If you have any of these symptoms, please see a medical professional even if your blood sugar levels are near normal. If our GP practice is closed please phone 111 and say you are worried about "Diabetic Keto-acidosis".
You may be given 'ketostix' which can test for ketones in your urine by the practice. If you are unwell and have ketones in your urine, you must seek medical help as mentioned above.
Is there anything more likely to cause this?
This can develop at any time.
You need to be especially careful if you develop an infection or undergo surgery.
If you have an operation planned discuss this medication with your doctor or nurse as they may need to be stopped, but do not stop them without discussing first.
If I feel unwell what will my doctor or nurse do?
A finger prick blood test or your urine will be tested for the amount of sugar and ketones present. If the ketone levels are high, your doctor or nurse will contact the diabetes team.
Are there any other things I should be aware of with this medication?
There is a rare complication of gangrene in the genital area. If you develop any genital pain, discharge, ulceration or smell in the genital area, please seek medical help.
Flozin Advice