Managing type 2 diabetes can be challenging and tackling inconsistencies in care is vital to ensuring patients have access to the most effective treatments. This section provides useful resources to help you provide optimal care, and a selection of key clinical papers and guidelines in the reference library.

SGLT2i Prescribing Tool

The Improving Diabetes Steering Committee, experts in the field of diabetes, reviewed the evidence available for the class and have made these recommendations based upon this evidence and in some cases expert opinion.

This SGLT2i Prescribing Tool is a quick reference guide to support clinicians with treatment decisions concerning SGLT2i therapies. The Tool aims to provide clarity regarding common areas of confusion in clinical practice associated with risk of lower limb amputations and bone fractures, late and early use of SGLT2i treatments within the T2DM pathway, and risk of diabetic ketoacidosis.

The traffic light system highlights the types of people or situations you may encounter in terms of risk:

Click each light to find out more
(Note – each colour shows a separate pop up with the relevant information)

HIGH RISK (red): Do not prescribe

MODERATE RISK (amber): Prescribe with caution

LOW RISK (green): Evidence supports SGLT2i prescribing in these situations

An evidence level has been assigned to each risk category, based on randomised control trial and observational data, as well as NICE/SIGN guidelines and the licensed indication for each therapy within the SGLT2i class of medicines.

The level of evidence has been scored according to the ADA Evidence-Grading System shown next to the risk category chart.

NB. Where data are conflicting or lacking, advice has been provided that is based upon expert opinion and experience in T2DM management
Abbreviations. T2DM, Type 2 diabetes mellitus; SGLT2i, sodium-glucose co-transporter-2 inhibitor; ADA, American Diabetes Association; RCT, randomised controlled trial; BMI, body mass index; PAD, peripheral arterial disease; CV, cardiovascular; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; UTIs, urinary tract infections; DKA, diabetic ketoacidosis; CKD, chronic kidney disease.

Adapted from: Wilding J, Fernando K, et al. SGLT2 Inhibitors in Type 2 Diabetes Management: Key Evidence and Implications for Clinical Practice. Diabetes Ther. 2018 Jul 23. https://rd.springer.com/article/10.1007/s13300-018-0471-8 [Accessed August 2019]
This article was supported by an educational grant from Napp, and was reviewed by Napp for factual accuracy only.

Download the SGLT2i Prescribing Tool

This prescribing tool, developed by the Improving Diabetes Steering Committee, offers evidence-based recommendations on which individuals will benefit most from an SGLT2i and when caution may be required, and uses a ‘traffic light’ system to support prescribing decisions.