Characteristics of selected studies Participants The studies involved patients diagnosed with PD, with ages ranging from 18 to 84 years
ulceration, gangrene Interactions Lithium: increased excretion lithium levels Diuretics, ACE inhibitors, ARBs: risk of dehydration and hypotension Insulin, sulfonylureas: risk of hypoglycaemia UGT inducers (rifampicin, phenytoin): canagliflozin/empagliflozin exposure Colestyramine: canagliflozin exposure Canagliflozin (P-gp inhibition) : digoxin and dabigatran exposure (P-gp substrates) References SGLT2 Inhibitors | Diabetes UK accessed 20/3/25 SGLT-2 inhibitors | Prescribing information | Diabetes type 2 | CKS | NICE accessed 20/3/2025 Forxiga 10 mg film-coated tablets Summary of Product Characteristics (SmPC) (emc) | 7607 accessed 20/3/2025 Jardiance 10 mg film-coated tablets Summary of Product Characteristics (SmPC) (emc) | 5441 accessed 26/3/2025 Invokana 100 mg film-coated tablets Summary of Product Characteristics (SmPC) (emc) | 8855 accessed 16/4/2025 Steglatro 5 mg Film-Coated Tablets Summary of Product Characteristics (SmPC) (emc) | 9803 accessed 23/4/2025
Continue metformin unchanged throughout the transition
The search for safer, even more effective protocols continues
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For some patients, a step-down option to a lower-burden oral GLP-1 is useful, either short-term to bridge the transition, or as a lighter form of long-term support if and when it is clinically appropriate
