Open Journal Systems

Assessment of current practice of prescription of SGLT2 inhibitors in a tertiary care hospital- an observational study

Gayatri Suresh KP, PL Saravanan, Shreya P Gudur, Balakeshwa Ramaiah



To assess the current prescribing practice of SGLT2 inhibitors in patients to understand and update the treatment plans for future patients.


  • To conduct an observational study to evaluate adherence to guidelines on prescription of SGLT2 inhibitors following Diabetes Mellitus.
  • To assess the indications and reasons for starting SGLT2 inhibitors and to evaluate the adverse drug reactions.


In this study, a sample size of 50 patients prescription details are checked and the current prescription practice of clinicians (indications, regimen and the duration) and is compared with existing guidelines. Another aspect of the study is to look at the clinical effectiveness (glycemic status and cardiac status) and the side effects encountered by the patients. Trends in new prescriptions and subsequent 3month adjusted changes in glycemic response (reduction in HbA1c), weight, blood pressure and rates of hypoglycaemia, creatinine levels and treatment discontinuation were examined.


In the assessment of prescribing patterns of 50 patients, a 69% of the prescriptions were following the guidelines and 22% were prescribed out of the guidelines and less than 9% the drug was discontinued, and accordingly, the justifications given for prescribing the drug was recorded and analysed. The drugs were found to cause a decrease in glycemic levels, increase in Creatinine levels and also showed urinary tract infections.


In the assessment of current prescribing patterns of SGLT2inhibitors, a major part of the prescriptions were following guidelines, at the same time, a good number of prescriptions were prescribed outside the guidelines. Therefore, appropriate guidelines for the prescription of SGLT2I should be developed which can promote uniform and appropriate prescription of the drugs that come under SGLT2I.


Sodium glucose co-transport inhibitor, Observational study,Diabetes mellitus, Prescribing patterns, Guidelines, Adverse drug reactions


Stewart J, Manmathan G, Wilkinson P. Primary prevention of cardiovascular disease: A review of contemporary guidance and literature. JRSM cardiovascular disease. 2017 Jan;6:2048004016687211.

2.Chu C, Lu YP, Yin L, Hocher B. The SGLT2 Inhibitor Empagliflozin Might Be a New Approach for the Prevention of Acute Kidney Injury. Kidney and Blood Pressure Research. 2019;44(2):149-57.

Filippatos TD, Liberopoulos EN, Elisaf MS. Dapagliflozin in patients with type 2 diabetes mellitus. Therapeutic advances in endocrinology and metabolism. 2015 Feb;6(1):29-41.

Effects of SGLT2 Inhibition in Human Kidney Proximal Tubular Cells—Renoprotection in Diabetic Nephropathy?

5.Scheen AJ. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Vol. 75, Drugs. 2015. p. 33–59.

6.Wilding J, Fernando K, Milne N, Evans M, Ali A, Bain S, et al. SGLT2 Inhibitors in Type 2 Diabetes Management: Key Evidence and Implications for Clinical Practice. Diabetes Ther [Internet]. 2018 Oct 23 [cited 2020 Jun 16];9(5):1757–73. Available from:

7.Carlson CJ, Santamarina ML. Update review of the safety of sodium-glucose cotransporter 2 inhibitors for the treatment of patients with type 2 diabetes mellitus. Vol. 15, Expert Opinion on Drug Safety. Taylor and Francis Ltd; 2016. p. 1401–12.


Wanner C, Heerspink HJL, Zinman B, Inzucchi SE, Koitka-Weber A, Mattheus M, et al. Empagliflozin and kidney function decline in patients with type 2 diabetes: A slope analysis from the EMPA-REG OUTCOME trial. J Am Soc Nephrol. 2018 Nov 1;29(11):2755–69.

Kato ET, Silverman MG, Mosenzon O, Zelniker TA, Cahn A, Furtado RHM, et al. Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus. Circulation. 2019 May 28;139(22):2528–36.

Association AD. 7. Approaches to glycemic treatment. Diabetes Care. 2016 Jan 1;39(Supplement 1):S52–9.

Care D, Suppl SS. 9. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetesd2019. Diabetes Care. 2019;42(January):S90–102.

Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: A review of current trends. Oman Med J. 2012;27(4):269–73.

Dhatariya K. Diabetes: the place of new therapies. Ther Adv Endocrinol Metab [Internet]. 2019 Jan 30 [cited 2020 Apr 13];10:204201881880759. Available from:

Menne J, Dumann E, Haller H, Schmidt BMW. Acute kidney injury and adverse renal events in patients receiving SGLT2-inhibitors: A systematic review and meta-analysis. Taal MW, editor. PLOS Med [Internet]. 2019 Dec 9 [cited 2020 Jun 18];16(12):e1002983. Available from:

Clinical Spectrum and Mechanism of Acute Kidney Injury in Patients With Diabetes Mellitus on SGLT-2 Inhibitors - PubMed [Internet]. [cited 2020 Jun 18]. Available from:

Szalat A, Perlman A, Muszkat M, Khamaisi M, Abassi Z, Heyman SN. Can SGLT2 Inhibitors Cause Acute Renal Failure? Plausible Role for Altered Glomerular Hemodynamics and Medullary Hypoxia. Vol. 41, Drug Safety. Springer International Publishing; 2018. p. 239–52.

Wilding J, Fernando K, Milne N, Evans M, Ali A, Bain S, et al. SGLT2 Inhibitors in Type 2 Diabetes Management: Key Evidence and Implications for Clinical Practice. Diabetes Ther [Internet]. 2018 Oct 23 [cited 2020 Jun 17];9(5):1757–73. Available from:

Gajjar K, Luthra P. Euglycemic Diabetic Ketoacidosis in the Setting of SGLT2 Inhibitor Use and Hypertriglyceridemia: A Case Report and Review of Literature. Cureus [Internet]. 2019 Apr 4 [cited 2020 Sep 24];11(4). Available from: /pmc/articles/PMC6553675/?report=abstract

Limenta M, Ho CSC, Poh JWW, Goh SY, Toh DSL. Adverse Drug Reaction Profile of SGLT2 Inhibitor-Associated Diabetic Ketosis/Ketoacidosis in Singapore and their Precipitating Factors. Clin Drug Investig. 2019 Jul 1;39(7):683–90.

FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes | FDA [Internet]. [cited 2020 Jun 17]. Available from:

Chaplin S. SGLT2 inhibitors and risk of genitourinary infections. Prescriber [Internet]. 2016 Dec 1 [cited 2020 Sep 24];27(12):26–30. Available from:

Unnikrishnan A, Kalra S, Purandare V, Vasnawala H. Genital infections with sodium glucose cotransporter-2 inhibitors: Occurrence and management in patients with type 2 diabetes mellitus. Indian J Endocrinol Metab [Internet]. 2018 Nov 1 [cited 2020 Sep 24];22(6):837. Available from:

Gill, Kaur P, Mahendru S, Mithal A. Adverse effect profile and effectiveness of sodium glucose co-transporter 2 inhibitors (SGLT2i) - A prospective real-world setting study. Indian J Endocrinol Metab. 2019;23(1):50.

Jardiance (empagliflozin) dosing, indications, interactions, adverse effects, and more [Internet]. [cited 2020 Sep 24]. Available from:

Full Text: PDF

Article Level Metrics


  • There are currently no refbacks.