{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:54:15Z","timestamp":1788998055974,"version":"build-2803163510"},"reference-count":79,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) (canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin), although initially developed as glucose-lowering drugs, provide significant beneficial effects on cardiorenal outcomes, including heart failure, regardless of type 2 diabetes status. Integration of SGLT-2is into clinical practice requires practical guidance for physicians about their use. To overcome physicians\u2019 clinical inertia for SGLT-2i use, including addressing safety, potentially a barrier to their use, a roundtable discussion with physicians from three specialties (cardiology, endocrinology, and nephrology) was conducted. This review summarizes the physicians\u2019 clinical experience and recommendations about SGLT-2i use across different patient populations, taking into consideration the beneficial effects of SGLT-2is and their safety. The key aspects discussed regarding SGLT-2i safety include acute effects on kidney function (estimated glomerular filtration rate acute dip upon SGLT-2i initiation and acute kidney injury), volume depletion, diabetic ketoacidosis, genitourinary infections, hyperkalemia, and hypoglycemia. To mitigate any potential risks related to SGLT-2i safety, physicians can make minor adjustments to an individual patient\u2019s treatment plan, while retaining the SGLT-2i cardiorenal benefits for effective disease management. Recognition by physicians that the benefits of SGLT-2i use on clinical outcomes outweigh the risks will result in the integration of SGLT-2is into clinical practice and lead to improved patient care and outcomes.<\/jats:p>","DOI":"10.3390\/jcm11206051","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T22:21:11Z","timestamp":1665699671000},"page":"6051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Physicians\u2019 Considerations and Practice Recommendations Regarding the Use of Sodium-Glucose Cotransporter-2 Inhibitors"],"prefix":"10.3390","volume":"11","author":[{"given":"Serge A.","family":"Jabbour","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College, Thomas Jefferson University, 211 S Ninth Street, Suite 600, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrien E.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"INOVA Heart and Vascular Institute, Falls Church, VA 22042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9679-7805","authenticated-orcid":false,"given":"Christos P.","family":"Argyropoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1002\/clc.23508","article-title":"The cardiovascular outcomes, heart failure and kidney disease trials tell that the time to use sodium glucose cotransporter 2 inhibitors is now","volume":"43","author":"Johansen","year":"2020","journal-title":"Clin. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E1128","DOI":"10.1503\/cmaj.190047","article-title":"Sodium-glucose cotransporter inhibitors in type 2 diabetes: Thinking beyond glucose lowering","volume":"191","author":"Neuen","year":"2019","journal-title":"CMAJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3370","DOI":"10.1016\/j.jacc.2018.08.2202","article-title":"Prescriber patterns of SGLT2i after expansions of U.S. Food and Drug Administration labeling","volume":"72","author":"Vaduganathan","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1007\/s00125-018-4654-7","article-title":"Development of SGLT1 and SGLT2 inhibitors","volume":"61","author":"Rieg","year":"2018","journal-title":"Diabetologia"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"543","DOI":"10.2147\/DMSO.S90662","article-title":"SGLT2 inhibitors\u2014An insulin-independent therapeutic approach for treatment of type 2 diabetes: Focus on canagliflozin","volume":"8","author":"Seufert","year":"2015","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/s41371-020-00393-4","article-title":"SGLT-2 inhibitors and nephroprotection: Current evidence and future perspectives","volume":"35","author":"Piperidou","year":"2021","journal-title":"J. Hum. Hypertens."},{"key":"ref_7","unstructured":"US Food and Drug Administration (2021, November 04). Guidance for Industry: Diabetes Mellitus\u2014Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes, Available online: https:\/\/www.fda.gov\/media\/71297\/download."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1056\/NEJMoa2004967","article-title":"Cardiovascular outcomes with ertugliflozin in type 2 diabetes","volume":"383","author":"Cannon","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1056\/NEJMoa1611925","article-title":"Canagliflozin and cardiovascular and renal events in type 2 diabetes","volume":"377","author":"Neal","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa1812389","article-title":"Dapagliflozin and cardiovascular outcomes in type 2 diabetes","volume":"380","author":"Wiviott","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jchf.2018.11.013","article-title":"Practical guide to prescribing sodium-glucose cotransporter 2 inhibitors for cardiologists","volume":"7","author":"Vardeny","year":"2019","journal-title":"JACC Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1007\/s00125-018-4663-6","article-title":"Use of SGLT2 inhibitors in type 2 diabetes: Weighing the risks and benefits","volume":"61","author":"Lupsa","year":"2018","journal-title":"Diabetologia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/nrneph.2016.170","article-title":"Renal, metabolic and cardiovascular considerations of SGLT2 inhibition","volume":"13","author":"DeFronzo","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.cjca.2019.11.036","article-title":"CCS\/CHFS heart failure guidelines: Clinical trial update on functional mitral regurgitation, SGLT2 inhibitors, ARNI in HFpEF, and tafamidis in amyloidosis","volume":"36","author":"McDonald","year":"2020","journal-title":"Can. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.amjmed.2017.04.009","article-title":"Cardiovascular protection by sodium glucose cotransporter 2 inhibitors: Potential mechanisms","volume":"130","author":"Staels","year":"2017","journal-title":"Am. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s00125-016-4157-3","article-title":"Targeting renal glucose reabsorption to treat hyperglycaemia: The pleiotropic effects of SGLT2 inhibition","volume":"60","author":"Vallon","year":"2017","journal-title":"Diabetologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1161\/CIRCULATIONAHA.117.030012","article-title":"Sodium glucose cotransporter-2 inhibition in heart failure: Potential mechanisms, clinical applications, and summary of clinical trials","volume":"136","author":"Lytvyn","year":"2017","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1136\/heartjnl-2020-318060","article-title":"Sodium-glucose co-transporter 2 inhibitor therapy: Mechanisms of action in heart failure","volume":"107","author":"Joshi","year":"2021","journal-title":"Heart"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1161\/CIRCULATIONAHA.119.040514","article-title":"The serendipitous story of SGLT2 inhibitors in heart failure","volume":"139","author":"Verma","year":"2019","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in patients with chronic kidney disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1056\/NEJMoa1811744","article-title":"Canagliflozin and renal outcomes in type 2 diabetes and nephropathy","volume":"380","author":"Perkovic","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1056\/NEJMoa1911303","article-title":"Dapagliflozin in patients with heart failure and reduced ejection fraction","volume":"381","author":"McMurray","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1056\/NEJMoa1515920","article-title":"Empagliflozin and progression of kidney disease in type 2 diabetes","volume":"375","author":"Wanner","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2022190","article-title":"Cardiovascular and renal outcomes with empagliflozin in heart failure","volume":"383","author":"Packer","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1056\/NEJMoa2107038","article-title":"Empagliflozin in heart failure with a preserved ejection fraction","volume":"385","author":"Anker","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_27","unstructured":"Boehringer Ingelheim (2022, February 25). Jardiance\u00ae (Empagliflozin Tablets), for Oral Use [Prescribing Information]. Available online: https:\/\/docs.boehringer-ingelheim.com\/Prescribing%20Information\/PIs\/Jardiance\/jardiance.pdf."},{"key":"ref_28","unstructured":"Janssen Pharmaceuticals (2021, November 02). Invokana\u00ae (Canagliflozin) Tablets, for Oral Use [Prescribing Information]. Available online: https:\/\/www.janssenlabels.com\/package-insert\/product-monograph\/prescribing-information\/INVOKANA-pi.pdf."},{"key":"ref_29","unstructured":"AstraZeneca (2021, November 02). Farxiga\u00ae (Empagliflozin) Tablets, for Oral Use [Prescribing Information]. Available online: https:\/\/den8dhaj6zs0e.cloudfront.net\/50fd68b9-106b-4550-b5d0-12b045f8b184\/0be9cb1b-3b33-41c7-bfc2-04c9f718e442\/0be9cb1b-3b33-41c7-bfc2-04c9f718e442_viewable_rendition__v.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 11. Chronic kidney disease and risk management: Standards of Medical Care in Diabetes\u20142022. Diabetes Care, 45, S175\u2013S184.","DOI":"10.2337\/dc22-S011"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes\u20142022. Diabetes Care, 45, S144\u2013S174.","DOI":"10.2337\/dc22-S010"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes\u20142022. Diabetes Care, 45, S125\u2013S143.","DOI":"10.2337\/dc22-S009"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1016\/j.jacc.2019.03.010","article-title":"2019 ACC\/AHA guideline on the primary prevention of cardiovascular disease","volume":"74","author":"Arnett","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/eurheartj\/ehz486","article-title":"2019 ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD","volume":"41","author":"Cosentino","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2020.06.019","article-title":"KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease","volume":"98","author":"Caramori","year":"2020","journal-title":"Kidney Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.jacc.2020.11.022","article-title":"2021 update to the 2017 ACC expert consensus decision pathway for optimization of heart failure treatment: Answers to 10 pivotal issues about heart failure with reduced ejection fraction: A report of the American College of Cardiology Solution Set Oversight Committee","volume":"77","author":"Maddox","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_38","unstructured":"Merck & Co (2022, February 25). Steglatro\u00ae (Ertugliflozin) Tablets, for Oral Use [Prescribing Information]. Available online: https:\/\/www.merck.com\/product\/usa\/pi_circulars\/s\/steglatro\/steglatro_pi.pdf."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/dom.13611","article-title":"A safety update on sodium glucose co-transporter 2 inhibitors","volume":"21","author":"Fitchett","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.jacc.2020.05.037","article-title":"2020 Expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes: A report of the American College of Cardiology Solution Set Oversight Committee","volume":"76","author":"Das","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.kint.2019.09.013","article-title":"The renal hemodynamic effects of the SGLT2 inhibitor dapagliflozin are caused by post-glomerular vasodilatation rather than pre-glomerular vasoconstriction in metformin-treated patients with type 2 diabetes in the randomized, double-blind RED trial","volume":"97","author":"Muskiet","year":"2020","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.kint.2020.10.031","article-title":"Characterization and implications of the initial estimated glomerular filtration rate \u2018dip\u2019 upon sodium-glucose cotransporter-2 inhibition with empagliflozin in the EMPA-REG OUTCOME trial","volume":"99","author":"Kraus","year":"2021","journal-title":"Kidney Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.2215\/CJN.02480221","article-title":"Clinical implications of an acute dip in eGFR after SGLT2 inhibitor initiation","volume":"16","author":"Heerspink","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.34067\/KID.0001172021","article-title":"eGFR decline after SGLT2 inhibitor initiation: The tortoise and the hare reimagined","volume":"2","author":"Weinstein","year":"2021","journal-title":"Kidney360"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2352","DOI":"10.1681\/ASN.2021020167","article-title":"Effects of dapagliflozin in stage 4 chronic kidney disease","volume":"32","author":"Chertow","year":"2021","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"E351","DOI":"10.1503\/cmaj.191283","article-title":"Use of sodium-glucose cotransporter-2 inhibitors and risk of acute kidney injury in older adults with diabetes: A population-based cohort study","volume":"192","author":"Iskander","year":"2020","journal-title":"CMAJ"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.2337\/dc17-1011","article-title":"Acute kidney injury in patients on SGLT2 inhibitors: A propensity-matched analysis","volume":"40","author":"Nadkarni","year":"2017","journal-title":"Diabetes Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1053\/j.ajkd.2020.03.019","article-title":"Acute kidney injury events in patients with type 2 diabetes using SGLT2 inhibitors versus other glucose-lowering drugs: A retrospective cohort study","volume":"76","author":"Rampersad","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e020237","DOI":"10.1161\/JAHA.120.020237","article-title":"Clinical implications of estimated glomerular filtration rate dip following sodium-glucose cotransporter-2 inhibitor initiation on cardiovascular and kidney outcomes","volume":"10","author":"Xie","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"70","DOI":"10.2215\/CJN.11220720","article-title":"Network meta-analysis of novel glucose-lowering drugs on risk of acute kidney injury","volume":"16","author":"Zhao","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1161\/HYPERTENSIONAHA.119.11684","article-title":"Antihypertensive and renal mechanisms of SGLT2 (sodium-glucose linked transporter 2) inhibitors","volume":"75","author":"Wilcox","year":"2020","journal-title":"Hypertension"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3402","DOI":"10.1093\/eurheartj\/ehaa496","article-title":"Effect of dapagliflozin according to baseline systolic blood pressure in the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure trial (DAPA-HF)","volume":"41","author":"Serenelli","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/ejhf.1531","article-title":"Clinical practice update on heart failure 2019: Pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Seferovic","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1479164120953625","DOI":"10.1177\/1479164120953625","article-title":"Risk of orthostatic hypotension associated with sodium-glucose cotransporter-2 inhibitor treatment: A meta-analysis of randomized controlled trials","volume":"17","author":"Rong","year":"2020","journal-title":"Diabetes Vasc. Dis. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1161\/CIRCULATIONAHA.116.024764","article-title":"Use of sodium glucose cotransporter 2 inhibitors in the hands of cardiologists","volume":"134","author":"Cherney","year":"2016","journal-title":"Circulation"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.aace.2020.11.009","article-title":"Euglycemic diabetic ketoacidosis caused by SGLT2 inhibitors and a ketogenic diet: A case series and review of literature","volume":"7","author":"Mistry","year":"2021","journal-title":"AACE Clin. Case Rep."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2654","DOI":"10.1016\/j.clinthera.2016.11.002","article-title":"SGLT2 inhibitor\u2013associated diabetic ketoacidosis: Clinical review and recommendations for prevention and diagnosis","volume":"38","author":"Goldenberg","year":"2016","journal-title":"Clin. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1111\/dom.13648","article-title":"Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type 2 diabetes mellitus and chronic kidney disease: A systematic review and meta-analysis","volume":"21","author":"Toyama","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/j.jdiacomp.2016.05.008","article-title":"Diabetic ketoacidosis, sodium glucose transporter-2 inhibitors and the kidney","volume":"30","author":"Palmer","year":"2016","journal-title":"J. Diabetes Complicat."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.2337\/dc15-0843","article-title":"Euglycemic diabetic ketoacidosis: A potential complication of treatment with sodium-glucose cotransporter 2 inhibition","volume":"38","author":"Peters","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3810\/pgm.2013.05.2650","article-title":"Genital mycotic infections in patients with diabetes","volume":"125","author":"Nyirjesy","year":"2013","journal-title":"Postgrad. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e001238","DOI":"10.1136\/bmjdrc-2020-001238","article-title":"Risk factors for genital infections in people initiating SGLT2 inhibitors and their impact on discontinuation","volume":"8","author":"McGovern","year":"2020","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1177\/1060028020951928","article-title":"Prevention and management of genital mycotic infections in the setting of sodium-glucose cotransporter 2 inhibitors","volume":"55","author":"Engelhardt","year":"2021","journal-title":"Ann. Pharmacother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.2337\/db19-1224-P","article-title":"Improving compliance with SGLT2 inhibitors by reducing the risk of genital mycotic infections: The outcomes of personal hygiene advice","volume":"68","author":"Williams","year":"2019","journal-title":"Diabetes"},{"key":"ref_65","unstructured":"Centers for Disease Control and Prevention (CDC) (2021, November 15). Vaginal Candidiasis, Available online: https:\/\/www.cdc.gov\/fungal\/diseases\/candidiasis\/genital\/index.html."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/dom.13886","article-title":"Fournier\u2019s gangrene in patients with type 2 diabetes using second-line antidiabetic medications","volume":"22","author":"Schneeweiss","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"78","DOI":"10.2337\/cd21-0015","article-title":"Sodium\u2013glucose cotransporter 2 inhibitor use associated with Fournier\u2019s gangrene: A review of case reports and spontaneous post-marketing cases","volume":"40","author":"Tran","year":"2022","journal-title":"Clin. Diabetes"},{"key":"ref_68","unstructured":"US Food and Drug Administration (2021, November 04). FDA Warns about Rare Occurrences of a Serious Infection of the Genital Area with SGLT2 Inhibitors for Diabetes, Available online: https:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm617360.htm."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1185\/03007995.2014.919907","article-title":"Effect of canagliflozin on serum electrolytes in patients with type 2 diabetes in relation to estimated glomerular filtration rate (eGFR)","volume":"30","author":"Weir","year":"2014","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1093\/ckj\/sfaa133","article-title":"Effects of canagliflozin on serum potassium in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program","volume":"14","author":"Weir","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"ehaa946.0939","DOI":"10.1093\/ehjci\/ehaa946.0939","article-title":"Dapagliflozin reduces the risk of hyperkalaemia in patients with heart failure and reduced ejection fraction: A secondary analysis DAPA-HF","volume":"41","author":"Kristensen","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.ekir.2021.12.013","article-title":"The kidney protective effects of the sodium\u2013glucose cotransporter-2 inhibitor, dapagliflozin, are present in patients with CKD treated with mineralocorticoid receptor antagonists","volume":"7","author":"Provenzano","year":"2021","journal-title":"Kidney Int. Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.jacc.2021.01.044","article-title":"Interplay of mineralocorticoid receptor antagonists and empagliflozin in heart failure: EMPEROR-Reduced","volume":"77","author":"Ferreira","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1007\/s12325-017-0573-0","article-title":"Safety and tolerability of empagliflozin in patients with type 2 diabetes: Pooled analysis of phase I-III clinical trials","volume":"34","author":"Kohler","year":"2017","journal-title":"Adv. Ther."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1001\/jama.2020.1906","article-title":"Effect of dapagliflozin on worsening heart failure and cardiovascular death in patients with heart failure with and without diabetes","volume":"323","author":"Petrie","year":"2020","journal-title":"JAMA"},{"key":"ref_76","unstructured":"US Food and Drug Administration (2021, November 02). Invokana (Canagliflozin) Tablets, for Oral Use [Prescribing Information], Available online: http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/204042s026lbl.pdf."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.2337\/dc17-1551","article-title":"Empagliflozin and assessment of lower-limb amputations in the EMPA-REG OUTCOME trial","volume":"41","author":"Inzucchi","year":"2018","journal-title":"Diabetes Care"},{"key":"ref_78","unstructured":"US Food and Drug Administration (2021, November 02). FDA Removes Boxed Warning about Risk of Leg and Foot Amputations for the Diabetes Medicine Canagliflozin (Invokana, Invokamet, Invokamet XR), Available online: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-removes-boxed-warning-about-risk-leg-and-foot-amputations-diabetes-medicine-canagliflozin."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 12. Retinopathy, neuropathy, and foot care: Standards of Medical Care in Diabetes\u20142022. Diabetes Care, 45, S185\u2013S194.","DOI":"10.2337\/dc22-S012"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6051\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:31Z","timestamp":1760144011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":79,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11206051"],"URL":"https:\/\/doi.org\/10.3390\/jcm11206051","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]}}}