What are common adverse effects of SGLT2 inhibitors besides DKA?

• A. Genital mycotic infections, volume depletion, hypotension, increased risk of AKI in dehydrated states.
• B. Weight gain and increased appetite.
• C. Hypoglycemia is the main risk.
• D. Hair loss.

Answer: (A)

SGLT2 inhibitors cause adverse effects that align with how these drugs work: they block glucose reabsorption in the kidney, so more glucose spills into the urine. That urinary glucose promotes fungal growth, leading to genital mycotic infections (and can raise urinary tract infection risk). The same mechanism also causes osmotic diuresis, which pulls water out with the glucose. This reduces the circulating volume, potentially causing hypotension and dizziness, especially in patients who are dehydrated or on diuretics. Dehydration can lower kidney perfusion and increase the risk of acute kidney injury in the right (or wrong, depending on context) conditions.

In addition, these effects are not about weight gain or hypoglycemia as the main risks; weight loss is more typical, and hypoglycemia is relatively uncommon unless paired with other glucose-lowering meds. Hair loss isn’t a characteristic adverse effect of this class.

So the best answer highlights genital infections, volume depletion with related hypotension, and increased AKI risk in dehydrated states, all rooted in the drug’s mechanism of increasing urinary glucose.