× Home Screening and diagnosis of type 2 diabetesGlycaemic monitoring and targets for type 2 diabetesLifestyle managementNon-insulin medicationsInsulinScreening and management of complications of diabetesManagement of cardiovascular risk factors in diabetesManagement of hypoglycaemiaSick day managementDiabetes in pregnancyDiabetes and drivingPrediabetesGo to the NZSSD site

Type 2 Diabetes Management Guidelines

SGLT2 inhibitors

  • Special Authority Criteria
  • Patient has type 2 diabetes with diabetic renal disease (urinary albumin:creatinine ratio > 3 mg/mmol and/or eGFR < 60 mL/min), known cardiovascular disease or 5 year CVD risk > 15%
  • Type 2 diabetes with HbA1c > 53 mmol/mol despite maximal tolerated dose of metformin and/or alternative glucose lowering therapy for 6 months
  • The patient is not on a funded GLP1RA

Fournier's gangrene is a type of necrotising fasciitis involving the external genitalia, perineal or perianal areas and may be life threatening. Although the vast majority of genitourinary infections associated with SGLT2 inhibitors are mild, consider acute referral to secondary care if significant pain, fevers and redness out of keeping with mild infection

References:

New Zealand Society for the Study of Diabetes. ALERT UPDATE - Periprocedural Diabetic Ketoacidosis (DKA) with SGLT2 Inhibitor Use. Available from: https://www.nzssd.org.nz/assets/table-files/resources-45-resource_file.pdf?title=SGLT2i+and+DKA+alert