Why are SGLT2 inhibitors withheld before elective surgery in patients with diabetes?
Answer and explanation
Correct answer: B. They raise the risk of euglycaemic ketoacidosis while fasted around surgery
- Step 1: Fasting and surgical stress promote ketone formation, and SGLT2 inhibitors further favour ketogenesis. Step 2. Ketoacidosis can occur with near-normal glucose, so it is easily missed. UK perioperative guidance advises omitting the drug the day before and on the day of surgery. Answer: They raise the risk of euglycaemic ketoacidosis while fasted around surgery. Why not the others: SGLT2 inhibitors have no interaction with muscle relaxants, do not cause bradycardia on anaesthesia and do not affect platelets.
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