Patients with Type 2 diabetes on Sodium-Glucose Co-Transporter 2 Inhibitors

Information for patients with T2DM on SGLT2 inhibitors. This patient information provides information regarding benefits, possible side effects including DKA and circumstances in which patients need to seek medical advice

What are SGLT2 Inhibitors?

  • SGLT2 inhibitors are a class of drug used in the treatment of diabetes.
  • They are available in tablet form and usually taken once daily.
  • They may be prescribed on their own or in combination with other diabetes medication including insulin.
  • They help lower blood glucose by reducing the reabsorption of glucose in the kidneys and allows glucose to be passed out in the urine.

Who are SGLT2 inhibitors suitable for?

This medication is used for the treatment of T2DM. Before starting this medication you should tell your doctor/diabetes specialist nurse if you have any of the following conditions:

  • Kidney disease.
  • Previous history of diabetic ketoacidosis (DKA).
  • Problems with recurrent urinary tract infections (UTI).
  • Problems with recurrent genital infections i.e. thrush.
  • History of peripheral vascular disease.
  • Alcohol dependency.
  • If they currently have foot ulcers.
  • Planning or are pregnant, or breast feeding.

If you have any of the above conditions, SGLT2 inhibitor may not be suitable for you.

What are the benefits of SGLT2 inhibitors?

  • Improvement in blood glucose.
  • Weight loss.
  • Lowering of blood pressure.
  • Lowering risks of death in people with heart attacks, heart failure and kidney failure.

What are the possible side effects of SGLT2 inhibitors?

Very common (≥1:10)

An increase in the risk of hypoglycaemia when used in combination with other diabetes medication (insulin/sulfonylureas).

Common (≥1:100 to <1:10)

  • Developing genital or urinary tract infections.
  • Passing more urine more often.
  • Increased thirst.
  • Itching/rash.

Uncommon (≥1:1000 to <1:100)

  • Low blood pressure and dehydration.
  • Difficulty passing urine.

Rare (≥1:10,000 to <1:1000)

  • Diabetic ketoacidosis (DKA).
  • Necrotising fasciitis of the perineum (Fournier’s gangrene) [pain, tenderness, erythema, or swelling in the genital or perineal area, with fever or malaise].

What is diabetic ketoacidosis (DKA)?

  • DKA is a rare but serious condition that can develop in people taking SGLT2 inhibitors. It is a serious condition which requires urgent medical treatment.
  • DKA usually occurs when the body does not have enough insulin, this results in the formation of ketone bodies leading to increasing acid levels in the blood.

What are the symptoms of DKA?

  • Nausea and vomiting.
  • Abdominal/stomach pain.
  • Rapid breathing.
  • Dehydration e.g. dizziness and excessive thirst.
  • A sweet or metallic taste in the mouth.
  • A different odour to urine or sweat.
  • Drowsiness or tiredness.
  • In some cases of DKA, blood glucose levels may be within normal range in people using SGLT2 inhibitors.

See your doctor urgently:

  • If you have a severe illness.
  • If you are dehydrated.
  • If you have significant weight loss and have poor appetite.
  • If there is excess alcohol use.
  • If you are on insulin treatment and there is a sudden reduction in insulin doses.

Stop taking your SGLT2 inhibitor in these circumstances:

  • At least 3 days before fasting for surgery or a procedure.
  • If you are unwell with an infection or illness.
  • If you are on a very low carbohydrate diet.

Always inform Health Care Professionals that you are taking this medication.

For further advice contact your diabetes team.

SGLT2 inhibitors available in UK


  • Invokana (Canagliflozin)
  • Vokanemet (Canagliflozin/Metformin)


  • Forxiga (Dapagliflozin)
  • Xigduo (Dapagliflozin/Metformin)
  • Qtern (Dapagliflozin/Saxagliptin)


  • Jardiance (Empagliflozin)
  • Glyxambi (Empagliflozin/Linagliptin)
  • Synjardy (Empagliflozin/Metformin)


  • Steglatro (Ertugliflozin)

Department: Diabetes Care

Site: Pan Trust

Lincoln/Grantham/Louth: 01522 573074

Boston: 01205 364801