SGLT-2 Inhibitors for Diabetes

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What are SGLT-2 inhibitors?

Sodium glucose co-transporter 2 (SGLT-2) inhibitors are tablets used to treat Type 2 diabetes. They work in the kidneys so that you pass extra glucose (sugar) in your urine.

Examples of SGLT-2 tablets are:

  • Empagliflozin (jardiance)
  • Dapagliflozin (forxiga)
  • Canagliflozin (ivokana)

What are the possible benefits?

  • better control of Type 2 diabetes - SGLT-2 inhibitors help to lower blood glucose (sugar)
  • weight loss
  • better control of blood pressure
  • living longer, improved survival in heart and kidney disease

What are the possible side effects?

  • increased risk of genital infections such as thrush or urinary tract infections (UTIs). Rarely, infections can be
    very serious and require hospital treatment you must seek medical attention urgently if you notice
  • swelling, redness or tenderness in the genitals or the skin between the genitals and the rectum (back passage)
  • or have a fever or feel unwell increased urination, thirst and tendency to become dehydrated
    nausea
    diabetic ketoacidosis (DKA) 
  • possible increased risk of needing a toe amputation

please tell your diabetes specialist if you have had problems with foot ulcers or operations to your feet

Diabetic Ketoacidosis (DKA)

DKA is a condition where the body does not have enough insulin and acid levels in the blood get too high
it is rare in Type 2 diabetes, but serious

What can you do to reduce DKA risk?

stop taking your SGLT-2 inhibitor:

3 days before an operation
if you are unwell with an infection or illness, or are unable to eat with nausea or vomiting
if you get symptoms of DKA (unwell with nausea and vomiting, abdominal pain, rapid breathing) then see
an emergency doctor, and tell them that you are on this medication and are worried about diabetic ketoacidosis (DKA)

check with a doctor before starting this medication again


Editorial Information

Last reviewed: 31/07/2024

Next review date: 31/07/2026

Author(s): Williamson R.

Approved By: Clinical Governance & Quality

Reviewer name(s): Williamson R.