Page 39 - Virtual Vascular Vol 11
P. 39
Surgery may put patients being treated with SGLT2 inhibitors at a higher risk of
euglycemic diabetic ketoacidosis (EuDKA). EuDKA is precipitated by peri-operative
conditions such as reduction of insulin, starvation or low carbohydrate diet, sepsis,
or dehydration.
Therefore:
• Canagliflozin, dapagliflozin, and empagliflozin should be discontinued 3 days
before scheduled surgery
• Ertugliflozin should be discontinued at least 4 days before scheduled surgery
• Blood glucose should be monitored after drug discontinuation and
appropriately managed before surgery
• The SGLT2 inhibitor may be recommenced once the patient’s oral intake is
back to baseline and any other risk factors for ketoacidosis are resolved
https://www.renalfellow.org/2020/09/08/sglt2-inhibitor-induced-euglycemic-diabetic-ketoacidosis/
39
