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NMIC Bulletin 2026 Vol.32 No.1 Sodium-glucose co-transporter 2 (SGLT2) inhibitors in cardiac and renal disease

22 September, 2026

  • Initially licensed for the management of type 2 diabetes (T2DM), large placebo-controlled trials have shown cardiovascular and renal benefits of sodium-glucose co-transporter 2 (SGLT2) inhibitors
  • In addition to their indication in the management of T2DM, the SGLT2 indicators dapagliflozin and empagliflozin are also licensed for the treatment of heart failure and chronic kidney disease.
  • SGLT2 inhibitors have been shown to be safe, with urinary tract and fungal genital infections among the most commonly reported adverse effects.
  • More serious, but less common adverse effects highly unlikely to affect people without diabetes include ketoacidosis, lower limb amputation and Fournier's gangrene.
  • 'Sick day guidance' should be provided to all those on SGLT2 inhibitor therapy, including advice that SGLT2 inhibitors should be held if acutely  unwell, especially if at risk of dehydration.