SGLT2 (Sodium-Glucose Co-Transport 2) inhibitors are a relatively new class of diabetes medication. They became available on the Australian PBS in 2013. 

SGLT2 inhibitor medications currently available in Australia include: Dapagliflozin (Forxiga), Empagliflozin (Jardiance), and Ertugliflozin (Steglatro). They also  come in combinations with:

• Metformin under the brand names Xigduo, Jardiamet, and Segluromet.
• DPP-4 inhibitor under the brand names: Glyxambi, Qtern and Steglujan.

How they work

SGLT 2 inhibitors block glucose from being re-absorbed in the kidney. They lower blood glucose levels by increasing the amount of glucose excreted by the kidney in the urine.

Possible side effects 

The most common side effects are urinary tract infections (UTI) and/or genital yeast infections. This is due to the increased glucose in the urine and around the genitals. Germs can grow in this glucose. It is important when taking this medication that you drink plenty of water to help prevent infection. If you have a history of these types of infection talk with your doctor.

Another side effect some people experience is increased urination. This could increase the risk of dehydration if you are not getting enough fluids or you are unwell. It is advised to take your tablet with a full glass of water.

SGLT2 inhibitors and sick days

Everyone with diabetes is encouraged to have a sick day plan. This plan provides advice and instructions on what to do regarding your diabetes, when you are unwell. Ensure you know what your sick day instructions are when taking SGLT2 inhibitors as the medication may need to be suspended. You could also be at risk of dehydration and/or an electrolyte imbalance. In rare cases this imbalance can progress to a condition known as ketoacidosis. Diabetes ketoacidosis is a life-threatening condition.

Ketoacidosis can be due to illness or prolonged fasting, undergoing surgical or medical procedures, vomiting, diarrhoea, dehydration or drinking too much alcohol. It is best to understand your risk. Have a discussion with your medical team. Your GP or diabetes educator can create a written sick day plan with you. 

Follow this link for more information on sick day plans.

If you would like to understand your diabetes medications better you can attend a two-hour face-to- face program called MedSmart. To register for a program near you go to the NDSS Support Programs page or call the NDSS Helpline on 1800 637 700.