Endocrine Abstracts

The introduction of sodium-glucose co-transporter 2 inhibitors (SGLT2i) has significantly transformed the management of several chronic conditions, including heart failure (HF), chronic kidney disease (CKD), and type 2 diabetes mellitus (T2DM). Despite their well-documented benefits, the use of SGLT 2 inhibitors is associated with specific risks, particularly during episodes of acute intercurrent illness. These risks necessitate careful management through the implementation of ‘sick day rules’—guidance for temporarily discontinuing SGLT2i during acute illnesses to prevent complications such as dehydration, acute kidney injury (AKI), and euglycemic diabetic ketoacidosis (DKA). According to the Health Service Executive (HSE) guidelines, SGLT2i should be temporarily withheld during such illnesses. At Sligo University Hospital, we assessed patient awareness of sick day rules among individuals prescribed SGLT 2 inhibitors. We conducted a face-to-face survey involving patients and caregivers between1st May 2025 and 10th July 2025. Eighty patients (mean age 68.2 ± 13.14 years; range 39–94; 52.5% female) were included. Indications: T2DM (73.75%), HF (43.75%), CKD (30%). Agents prescribed were dapagliflozin (71.25%), empagliflozin (25%), canagliflozin (3.75%). Most (71.25%) had used SGLT2i for between one to five years. Awareness of sick day rules was as follows: 35% fully aware, 3.75% partially aware (vomiting/diarrhoea only), and 61.25% unaware. Awareness rates were 39% in diabetic patients, 33% in CKD, and only 20% HF. Improved patient education strategies are necessary to mitigate avoidable adverse events and to enhance the safety of SGLT2i therapy during episodes of acute illness.