Which statement best describes a known infection-related risk associated with SGLT2 inhibitors?

• A. Urinary tract infections
• B. Respiratory infections
• C. Genital infections
• D. Genital fungal infections and rare ketoacidosis; assess for dehydration.

Answer: (D)

SGLT2 inhibitors work by blocking glucose reabsorption in the kidney, so more glucose is excreted in the urine. That glucose-rich urine provides a favorable environment for fungal growth in the genital area, increasing the risk of genital fungal infections. They can also cause a rare form of ketoacidosis, sometimes with only mildly elevated blood glucose (euglycemic ketoacidosis); dehydration can worsen this risk, so checking hydration status is important. While urinary tract infections and respiratory infections can occur in general, the most well-described infection-related risks with these drugs are genital fungal infections and the potential for rare ketoacidosis, with dehydration assessment helping to mitigate that risk.