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Publication Type: Medication Safety Notice
Single or Multiple Incident: Multiple
Date: 5/1/2018 12:00:00 AM
Country: Australia

The purpose of this safety notice is to raise awareness of the potential occurrence of severe euglycaemic ketoacidosis associated with the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) in the perioperative period. SGLT2is are oral medications that promote glucose excretion in the urine for the treatment of type 2 diabetes. The notice provides information on the risk of severe diabetic ketoacidosis (DKA) despite near normal or mildly elevated glucose levels. It identifies that SGLT2i may reduce urinary ketone excretion, making urine ketone testing unreliable; blood ketone testing is required. Recommendations to prevent DKA in patients on SGLT2is are provided.

Additional Details

Medication/Gas/Fluid:
oral hypoglycemics, sodium-glucose co-transporter-2 inhibitors (SGLT2i), dapagliflozin (Forxiga®), dapagliflozin + metformin (Xigduo XR®), empagliflozin (Jardiance®), empagliflozin + metformin (Jardiamet®), empagliflozin + linagliptin (Glyxambi®)
Medication/IV List:
hypoglycemics, oral


Severe euglycaemic ketoacidosis with sodium-glucose co-transporter-2 inhibitors (SGLT2i) in the perioperative period