At the New England Institute of Ambulatory Care Pharmacists forum, experts highlight the critical need for routine sick-day guidance for patients on SGLT2 inhibitors to prevent serious complications during illness or planned procedures.
At the New England Institute of Ambulatory Care Pharmacists annual forum in Boston, Katelyn O’Brien of Boston Medical Center urged pharmacists to make sick-day advice a routine part of prescribing sodium-glucose cotransporter 2 inhibitors, or SGLT2 inhibitors. O’Brien, a clinical pharmacy specialist in endocrinology, said patients need to understand not only how these drugs work, but when to pause them safely.
SGLT2 inhibitors are widely used in type 2 diabetes and are also prescribed for chronic kidney disease and heart failure. Kidney specialists say the medicines help the kidneys remove excess glucose in urine and can lower the risk of heart attacks, stroke and worsening heart failure, while also reducing markers of kidney damage. Cleveland Clinic and the National Kidney Foundation note that the class can also aid weight loss and lower blood pressure.
O’Brien said the key safety message is to hold the medicine during acute illness, such as influenza or COVID-19, and before planned procedures, to reduce the risk of euglycaemic diabetic ketoacidosis, a dangerous form of diabetic ketoacidosis that can occur even when blood sugar is not very high. She said that advice should be repeated over time, not just at the start of treatment, because long-term users may forget it if they have not been unwell for some time.
She also described how safe medication changes depend on the wider pharmacy team. At her hospital, technicians help with prior authorisations and coordination with outpatient pharmacies, while retail pharmacists help prevent duplicate treatment. O’Brien said communication matters when medicines are stopped or changed, particularly when clinicians are trying to reduce low blood sugar risk or avoid unnecessary refills after a drug has been removed from a patient’s profile.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
