A 45-year-old woman visits the office for a check-up on her type 2 diabetes mellitus. After experiencing polyuria, polydipsia, and recurrent vulvovaginal candidiasis, the patient was diagnosed with diabetes three years ago. She tried lifestyle changes first, but there was no significant glycemic improvement, so she was put on metformin. The patient follows her therapy and eats a low-carbohydrate diet. Her mother's osteoporotic fracture has a significant family history. The blood pressure is 134/86 mm Hg, and the pulse rate is 72 / min. The BMI is 33 kg/m2². A physical examination reveals no anomalies. The hemoglobin A1c level measured in the lab is 8.2 percent. After further discussion, a sodium-glucose cotransporter-2 inhibitor is added to the patient's drug regimen. Which of the following is the most likely additional effect of the newly prescribed medication?

Question

Quizplus · Accepted Answer

Eductional Objective: Sodium-glucose cotransporter 2 inhibitors (eg, canagliflozin, dapagliflozin) decrease renal reabsorption of glucose and sodium, leading to lower blood glucose levels.  The decreased reabsorption of sodium and glucose also induces osmotic diuresis, which causes a decrease in blood pressure.  Excess urinary glucose also leads to an increased risk for genitourinary tract infections.

A 45-Year-Old Woman Visits the Office for a Check-Up on Her