امرأة عمرها ٦٤ سنة عندها فشل قلب مع ضعف ضخ البطين، وليست مصابة بالسكري. أُضيف لعلاجها داباغليفلوزين، والسكر ٩٨ والكرياتينين مستقر. ستخرج للبيت بعد يومين. ما الأهم في تعليمها؟

A 64-year-old non-diabetic woman with reduced-EF heart failure has dapagliflozin added; glucose is 98 mg/dL and creatinine stable. She goes home in two days. What is most important in her teaching?

1. Take it only when her body swells because it is a fast diuretic
2. Check glucose four times daily because the drug causes severe hypoglycaemia in people without diabetes
3. Signs of urinary or genital infection, and pausing it when ill and not eating
4. Avoid water completely because the drug retains fluid

Answer: C) Signs of urinary or genital infection, and pausing it when ill and not eating. SGLT2 inhibitors put glucose into the urine, raising urinary and genital fungal infections, and rarely cause ketoacidosis even with normal glucose, especially with acute illness or fasting. Hypoglycaemia is rare without other diabetes drugs.