Question of the Week Rationale – 02/01

Question of the Week & Rationale 

Our “Question of the Week” is created weekly by Coach Beverly to cover a variety of Diabetes related topics. The questions are designed to keep you current and prepare you for the CDE® Exam.

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This week’s Rationale: Question of the Week – January 30th – test your knowledge before seeing answer below! 

What a perfect way to information share and bring new concepts to light. We appreciate our community of diabetes educators and the opportunity to keep learning together! 



Ertugliflozin (Steglatro) is a newly approved SGLT-2 Inhibitor. Teaching points for patients include which of the following?

a. This medication frequently causes nausea

b. Only take this medication on empty stomach

c. Expect decreased urination

d. Report any signs of DKA immediately

Correct Answer: d. Report any signs of DKA immediately


Medications in the SGLT-2 Inhibitor Category decrease glucose reabsorption in the renal tubules. They are often referred to as “glucoretics”,  which is associated with increased urination. This class of medication doesn’t cause nausea and it is not necessary to take this med on an empty stomach.  Possible side effects include genital infections, orthostatic hypotension and ketoacidosis.

Ketoacidosis usually occurs in the following situation. Patients with type 1 or type 2 diabetes on insulin, may have a SGLT-2 Inhibitor added to their insulin regimen. This causes insulin needs to decrease and the patient may become insulin deprived (even though their BG levels may not be very elevated, since the SGLT- 2 Inhibitor is releasing extra sugar).  With a decrease in the insulin dose, the insulin dependent patient may not have enough insulin on board to prevent ketosis, the breakdown of fat for fuel.  For this reasons, patients on SGLT-2 Inhibitors at risk of ketosis, should inject sufficient insulin and monitor for ketones as needed.

For more information:  

Download our updated FREE Injectables PocketCard

Or join our Medication Update webinar! 

Meds Update 2018– Earn 1.5 CE – $29

Live webinar session February 19th, 2018 at 11:30 a.m. – 1:15 p.m. PST

Feeling overwhelmed by all the new recently approved diabetes medications? Two bio-similiar insulins are now available and another GLP-1 RA was just approved. Plus, 2 new combo oral meds are now available.

If you want cutting edge information on the latest pharmacology and hospital glucose management, we highly recommend this Meds Update.