This is general health information only and is not a substitute for advice from your GP or healthcare professional.
1. What are SGLT2 inhibitors?
SGLT2 inhibitors are a group of medicines that help lower blood glucose by reducing the amount of glucose reabsorbed by the kidneys. The excess glucose is then passed out of the body in the urine. They are commonly used to treat type 2 diabetes and are also used to protect the heart and kidneys in certain people, including some without diabetes.
2. How do SGLT2 inhibitors work?
SGLT2 inhibitors block a protein called sodium-glucose cotransporter 2 in the kidneys. This reduces glucose and sodium reabsorption, increasing their excretion in the urine. The resulting effects can also reduce pressure within the kidney and improve cardiovascular outcomes.
3. Which medicines are SGLT2 inhibitors?
Common SGLT2 inhibitors include empagliflozin, dapagliflozin, canagliflozin, and ertugliflozin. The medicines available and their approved uses vary between countries.
4. Who may benefit from SGLT2 inhibitors?
They are commonly prescribed for people with type 2 diabetes who require additional glucose lowering. Depending on the specific medicine and clinical circumstances, SGLT2 inhibitors may also benefit people with chronic kidney disease or heart failure by reducing the risk of hospitalisation and slowing kidney disease progression.
5. Do SGLT2 inhibitors cause weight loss?
SGLT2 inhibitors can cause modest weight loss because glucose and calories are lost through the urine. They are not primarily weight-loss medicines, and the amount of weight lost varies between individuals.
6. What are the common side effects?
The most common side effects are genital fungal infections and, less commonly, urinary tract infections. Increased urination can also occur because more glucose and fluid are excreted through the kidneys. Maintaining appropriate hydration is important, particularly during hot weather or illness.
7. Can SGLT2 inhibitors cause low blood sugar?
SGLT2 inhibitors have a relatively low risk of hypoglycaemia when used alone because they do not directly stimulate insulin release. However, the risk increases when they are combined with insulin or sulfonylureas, and medication doses may sometimes need adjustment.
8. What is diabetic ketoacidosis and can SGLT2 inhibitors cause it?
SGLT2 inhibitors can rarely cause diabetic ketoacidosis (DKA), sometimes even when blood glucose is not extremely high. The risk is increased during prolonged fasting, severe illness, dehydration, very low carbohydrate intake, or around major surgery. Symptoms such as nausea, vomiting, abdominal pain, unusual fatigue, or rapid breathing require urgent medical assessment.
9. Should SGLT2 inhibitors be stopped during illness or before surgery?
SGLT2 inhibitors are usually temporarily withheld during significant acute illness, prolonged fasting, dehydration, or before certain surgical procedures to reduce the risk of ketoacidosis. The appropriate timing for stopping and restarting depends on the individual circumstances and should be discussed with a healthcare professional.
10. When should I seek medical advice while taking an SGLT2 inhibitor?
Urgent medical assessment is required if you develop severe nausea or vomiting, abdominal pain, difficulty breathing, marked weakness, confusion, or symptoms of dehydration, as these may indicate ketoacidosis or another serious complication. Medical advice should also be sought for persistent genital infections, severe urinary symptoms, or any unexpected side effects.