Risk of diabetic ketoacidosis associated with sodium-glucose cotransporter-2 inhibitors

HSA would like to alert healthcare professionals that sodium-glucose cotransporter-2 (SGLT2) inhibitors have been associated with the potential risk of developing diabetic ketoacidosis (DKA), some of which are euglycaemic DKA.  HSA has assessed the benefit-risk profile of SGLT2 inhibitors and found that while it remains favourable for their approved indications, the possibility of SGLT2 inhibitors use leading to an increased risk of DKA cannot be excluded, particularly in the presence of predisposing factors. Healthcare professionals are advised to use SGLT2 inhibitors according to the licensed indications and be cautious with their use in patients with predisposing factors to DKA. Patients on SGLT2 inhibitors who present with metabolic acidosis should be assessed for ketoacidosis and tested for blood ketones, even when their blood glucose levels are not high. Please refer to the Dear Healthcare Professional Letter for more details.

Healthcare professional, Therapeutic Products

Dear Healthcare Professional Letters

12 Dec 2019

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of the letters can be found on the MOH Alert System, which is accessible via the Health Professionals Portal (HPP). HPP is a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://www.moh.gov.sg/hpp/, and follow the procedures below to access the MOH Alert system.

Step 1: On the top navigation ribbon of webpage, select 'For Healthcare Professionals' followed by 'Health Professionals Portal' and click on the choice of profession. User will be redirected to the specific HPP webpage for the selected profession.

Step 2: Click on the Restricted Content icon on the left panel of webpage and login via SingPass.

Step 3: Click on the MOH Alert icon under ‘Applications’ section

Step 4: Click on the Drug Alert tab to view the DHCPLs.