Sodium-glucose co-transporter 2 (SGLT2)-inhibitors are increasingly
being prescribed by cardiovascular clinical teams for patients with
heart failure with and without diabetes mellitus.
The cardiovascular teams should be aware of recent Food and Drug
Administration (FDA) advisory warnings for increased incidence of
euglycemic diabetic ketoacidosis when SGLT2-inhibitors medications are
continued prior to non-cardiac surgeries.
These warnings have stated that continuing SLGT2-inhibitors
preoperatively can lead to poor patient outcomes and increased hospital
length of stay.
When caring for patients being referred for surgery it is important to
advise patients to
stop their SGLT2-inhibitors 3-4 days prior to surgery
to minimize the risk of postoperative ketoacidosis and urinary tract
infections.
