{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:48:01Z","timestamp":1789559281552,"version":"build-2803163510"},"reference-count":75,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sodium\u2010glucose co\u2010transporter 2 inhibitors are a novel class of antihyperglycaemic drugs used in the management of type 2 diabetes, that improve glycaemic control, cardiovascular outcomes and promote weight loss. They are also approved for the treatment of heart failure and chronic kidney disease in patients with or without diabetes. This narrative review discusses the peri\u2010operative effects and implications of sodium\u2010glucose co\u2010transporter 2 inhibitors and gives an overview of current evidence and existing peri\u2010operative guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a literature review to identify peer\u2010reviewed English language articles published since 2000, with further articles identified by reviewing the references of key papers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Peri\u2010operative sodium\u2010glucose cotransporter 2 inhibitor use carries a risk of euglycaemic ketoacidosis. Although clinically significant diabetic ketoacidosis remains a rare event, sodium\u2010glucose co\u2010transporter 2 inhibitors inhibitor\u2010associated diabetic ketoacidosis has been observed across almost all surgical specialities. Ketoacidosis may present with any blood glucose level. Existing guidelines are inconsistent and may be a source of clinical confusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Based on the half\u2010life of sodium\u2010glucose cotransporter 2 inhibitors, we recommend withholding treatment for 72\u2009h before elective surgery (5 half\u2010lives), with additional multidisciplinary input for specific procedures with dietary alterations and in patients with poorly controlled diabetes of cardiac\/renal disease. In the event of emergency surgery or any surgery within 72\u2009h of sodium\u2010glucose cotransporter 2 inhibitor administration, we recommend pre\u2010, intra\u2010 and postoperative blood ketone monitoring (6 hourly for 24\u2009h post\u2010surgery and until full oral diet is resumed). Sodium\u2010glucose cotransporter 2 inhibitor treatment should only be resumed after resumption of full oral diet in the absence of ketosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16461","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:09:19Z","timestamp":1730938159000},"page":"85-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The peri\u2010operative implications of sodium\u2010glucose co\u2010transporter 2 inhibitors: a narrative review"],"prefix":"10.1111","volume":"80","author":[{"given":"Paul A.","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Tallaght University Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire C.","family":"Nestor","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Tallaght University Hospital  Dublin 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