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