What should I do if I take an SGLT2-inhibitor - Forxiga (dapagliflozin), Invokana (canagliflozin), Jardiance (empagliflozin), Steglatro (ertugliflozin)?

Canagliflozin, Dapagliflozin, Empagliflozin and Ertugliflozin are from a class of medication called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Most people taking these medications will have type 2 diabetes but some may have type 1 diabetes. People taking these medications are at increased risk of Diabetic Ketoacidosis (DKA). This could happen even with normal blood glucose levels. DKA is rare in people with type 2 diabetes but it is a serious condition and could be life-threatening.

If you are taking any of these medications and feeling unwell we suggest you stop them till you are feeling better. It is important to keep well hydrated.

If you have symptoms suggestive of DKA (for example, excessive thirst, dehydration, vomiting, fast breathing, feeling drowsy, abdominal pains) we suggest that you stop taking these tablets, keep well hydrated, and follow the advice below:
-              If you have type 2 diabetes and you do not have access to a blood ketone meter. Please follow advice from this link: Trend UK: Type 2 Diabetes and DKA.

-              If you have type 2 diabetes and have access to a blood ketone meter, please measure your blood ketone level:
•  If ketone is normal (<0.6 mmol/L), please follow advice from this link: TREND UK: Type 2 diabetes: what to do when you are ill.
• If ketone is raised (>0.6 mmol/L) then contact 111.

-              If you have type 1 diabetes, please measure your blood ketone level and follow advice from this link: TREND UK: Type 1 diabetes: what to do when you are ill.
-              If your symptoms are getting worse or you think you are developing DKA then call 111.