SGLT2 inhibitors and COVID-19
Key messages
- Secondary care clinical teams in NHSGGC will review patients with type 1 diabetes on sodium-glucose co-transporter 2 (SGLT2) inhibitors during the COVID-19 pandemic.
- Patients with type 1 diabetes should not make any changes to their medication without consultation with their secondary care diabetes team.
- SGLT2 inhibitors can be continued safely in patients with type 2 diabetes unless they become unwell. See below for information on ‘sick day rules’.
The Scottish Diabetes Group (SDG) Update from the 30th April was circulated to GP practices and included information on patients with type 1 diabetes taking SGLT2 inhibitors.
While SGLT2 inhibitors are widely used in type 2 diabetes patients, they are also used in a small number of patients with type 1 diabetes.
The SDG Update relates only to patients with type 1 diabetes. These patients will be reviewed by the secondary care clinical teams who will decide on the appropriateness to continue or stop the SGLT2 inhibitor.
The following is advice from the NHSGGC Diabetes MCN:
Stopping SGLT2 Inhibitors in those with Type 1 Diabetes:
The UK In-patient Diabetes COVID-19 Response Group which links in with ABCD (Association of British Clinical Diabetologists) and Diabetes UK are advising that all patients with Type 1 Diabetes who are on a SGLT2 inhibitor should STOP taking this at this time due to the potential risk of diabetic ketoacidosis (DKA) associated with both SGLT2 inhibitor use and COVID-19 infection.
Action: Secondary care clinical teams will assess and contact relevant patients to discuss this further.
Type 2 Diabetes:
SGLT2 inhibitors can be continued safely in patients with Type 2 Diabetes unless they become unwell, in which case “sick day rules” guidance should be followed.
SGLT2 inhibitors, ACE-Is/ARBs, diuretics, metformin and NSAIDs should be temporarily stopped until a patient is feeling better and able to eat and drink for at least 24-48 hours.
Current sick day guidance for at risk medicines is available HERE.
Published 02/06/2020. Medicines Update blogs are correct at the time of publication.