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SGLT2i Prescribing Tool

The 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, such as early and late use of SGLT2i treatments within the T2DM pathway, the risk of diabetic ketoacidosis and lower limb amputations or bone fractures.

The SGLT2i Prescribing Tool has been independently prepared by the Improving Diabetes Steering Committee. Napp Pharmaceuticals has fully funded the creation of this non-promotional document and has reviewed and certified it for medical accuracy and compliance with the ABPI Code of Practice.

The traffic light system highlights the types of people or situations you may encounter and appropriate approaches to prescribing in these cases:

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

Traffic lights


Red: Do not prescribe SGLT2i

Amber: Prescribe SGLT2i with caution

Green: Evidence supports SGLT2i prescribing in these situations

An evidence level has been assigned to each category, based on randomised controlled trial (RCT) 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.1

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 October 2020]
This article was supported by an educational grant from Napp, and was reviewed by Napp for factual accuracy only.

The SGLT2i Prescribing Tool has been independently prepared by the Improving Diabetes Steering Committee. Napp Pharmaceuticals has fully funded the creation of this non-promotional page and has reviewed and certified it for medical accuracy and compliance with the ABPI Code of Practice.

Reference: 1. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2017;40(1):S1–2.

DOWNLOAD THE SGLT2I PRESCRIBING TOOL

SGLT2i Prescribing Tool image

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 ʻtraffic light ʼ system to support prescribing decisions.

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