Dr. John Buse prepared useful practice aids pertaining to type 2 diabetes for this CME activity titled "An Update on SGLT2 Inhibition for the Prevention and Treatment of Kidney Disease in Patients With Type 2 Diabetes." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2Wm2VJw. CME credit will be available until June 12, 2020.

1. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Kidney Disease Outcomes and Quality Improvement
(KDOQI) CKD Staging Nomenclature1
CKD: chronic kidney disease; GFR: glomerular filtration rate.
1. National Kidney Foundation. Kidney Int Suppl. 2013;3:i-xiii,1-150.
PRACTICE AID
Access the activity, “An Update on SGLT2 Inhibition for the Prevention and Treatment of Kidney Disease in
Patients With Type 2 Diabetes,” at PeerView.com/XRN40.
G1
GFR ≥90
G2
GFR 60-89
G3a
GFR 45-59
G3b
GFR 30-44
G4
GFR 15-29
G5
GFR <15
A1
<30 mg/g
A2
30-300 mg/g
A3
>300 mg/g
Risk of CKD Progression
Low
Moderately increased
High
Very high
Worsening
albuminuria
Worsening GFR (stage)

2. Access the activity, “An Update on SGLT2 Inhibition for the Prevention and Treatment
of Kidney Disease in Patients With Type 2 Diabetes,” at PeerView.com/XRN40.
Cautions, Contraindications, Box Warnings, and
Common Adverse Events Noted in Prescribing
Information for Approved SGLT2 Inhibitors1,2
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
ESRD: end-stage renal disease; PVD: peripheral vascular disease; SGLT2: sodium-glucose cotransporter 2.
1. Das SR et al. J Am Coll Cardiol. 2018;72:3200-3223. 2. http://www.accessdata.fda.gov/scripts/cder/daf/. Accessed April 30, 2019.
PRACTICE AID
Hx of serious hypersensitivity
reactions
Severe renal impairment,
ESRD, dialysis
Contraindications
Hypovolemia, especially in patients with renal impairment, low
systolic BP, or older adults
Hypoglycemia, if used with insulin or sulfonylureas; dose
adjustment may be needed
Euglycemic ketoacidosis in vulnerable patients, including
those treated with insulin
Increased risk of genital mycotic infections
Hx prior amputation, severe PVD, neuropathy, foot ulcers
(canagliflozin and ertugliflozin only)
Hx osteoporosis (canagliflozin only)
Bone fracture risk (canagliflozin only)
Cautions
Canagliflozin
• Lower extremity amputation risk
BoxWarnings
CommonAdverseEvents
Canagliflozin
• Female genital mycotic
infections
• Urinary tract infections
• Increased urination
Empagliflozin
• Urinary tract infections
• Female genital mycotic
infections
Dapagliflozin
• Female genital mycotic
infections
• Nasopharyngitis
• Urinary tract infectionsErtugliflozin
• Female genital mycotic
infections

3. Current Renal Restrictions on Approved
SGLT2 Inhibitors1,a
a
Please note that the prescribing information for individual agents is likely to change over time as further data are obtained. Consult reputable online sources for the most recently approved prescribing information. b
No recommendation stated.
eGFR: estimated glomerular filtration rate; SGLT2: sodium-glucose cotransporter 2.
1. http://www.accessdata.fda.gov/scripts/cder/daf/. Accessed April 30, 2019.
PRACTICE AID
Access the activity, “An Update on SGLT2 Inhibition for the Prevention and Treatment of Kidney Disease in
Patients With Type 2 Diabetes,” at PeerView.com/XRN40.
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
0 15 30 45 60 75 90
Canagliflozin
Ertugliflozin
Dapagliflozin
Empagliflozin
eGFR, mL/min/1.73 m2
Do not use
Not recommended
Discontinue use
Limit dose
Do not initiate
Unrestricted use
b