Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose by inducing glucosuria. This mechanism has several physiological consequences that require monitoring. The induced osmotic diuresis can lead to volume depletion, dehydration, and hypotension, making it essential to monitor hydration status (A) and blood pressure (B). As these are antidiabetic medications, blood glucose (C) must be monitored to assess efficacy and the risk of hypoglycemia, especially when used with other glucose-lowering agents. Since SGLT2 inhibitors act directly on the kidneys and can cause an initial decline in the estimated glomerular filtration rate (eGFR), renal function (D) must be assessed at baseline and periodically thereafter. Therefore, all listed parameters are critical for safe and effective therapy.

A. Incorrect because it is an incomplete answer; blood pressure, glucose, and renal function also require monitoring.

B. Incorrect because it is an incomplete answer; hydration status, glucose, and renal function also require monitoring.

C. Incorrect because it is an incomplete answer; hydration status, blood pressure, and renal function also require monitoring.

D. Incorrect because it is an incomplete answer; hydration status, blood pressure, and glucose also require monitoring.

1. U.S. Food and Drug Administration (FDA). (2023). JARDIANCE® (empagliflozin) tablets

for oral use. Prescribing Information. Boehringer Ingelheim Pharmaceuticals

Inc. See Sections 2.2 (Recommended Dosage and Administration - Renal Function)

5.2 (Hypotension)

and 5.4 (Acute Kidney Injury and Impairment in Renal Function). Available at: https://www.accessdata.fda.gov/drugsatfdadocs/label/2023/204629s033lbl.pdf

2. American Diabetes Association Professional Practice Committee. (2023). 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2023. Diabetes Care

46(Supplement1)

S140–S157. See Table 9.3

which outlines drug-specific and patient factors to consider for SGLT2 inhibitors

including eGFR

volume depletion risk

and blood pressure effects. DOI: https://doi.org/10.2337/dc23-S009

3. Heerspink

H. J. L.

Stefánsson

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D. C. (2020). Dapagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine

383(15)

1436–1446. This article discusses the renal and cardiovascular effects of SGLT2 inhibitors

highlighting the importance of monitoring renal function (eGFR) and blood pressure. DOI: https://doi.org/10.1056/NEJMoa2024816