Exploration of Cardiology

Table 4. Safety considerations and recommended monitoring strategies for SGLT2 inhibitor therapy.

Adverse effect	Incidence	High-risk populations	Mechanism	Prevention strategies	Monitoring recommendations
Genital mycotic infections	Common	Females, prior infections	Glycosuria promoting fungal growth	Hygiene education, early antifungal therapy	Monitor for symptoms after initiation
Volume depletion	Moderate	Elderly, diuretic users	Osmotic diuresis	Dose adjustment of diuretics	Monitor BP and hydration status
EDKA	Rare	Insulin-deficient states, acute illness	Increased ketogenesis	Withhold drug during illness or surgery	Monitor ketone levels in symptomatic patients
Lower limb amputation	Controversial, rare	Peripheral vascular disease	Possibly volume and vascular effects	Careful foot monitoring	Regular foot examination
Acute kidney injury	Rare	Dehydrated or volume-depleted patients	Transient renal hemodynamic changes	Ensure adequate hydration	Monitor renal function after initiation
Hypotension	Occasional	Frail elderly	Volume contraction	Gradual drug initiation	BP monitoring during early therapy

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BP: blood pressure; EDKA: euglycemic diabetic ketoacidosis.

Declarations

Author contributions

NT: Conceptualization, Writing—original draft, Writing—review & editing. AWI: Conceptualization, Writing—original draft, Writing—review & editing, Supervision. PD, TP, MRM, MA, SRM, and BT: Writing—original draft, Writing—review & editing. All authors read and approved the final version of this manuscript.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

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