When you take an SGLT2 inhibitor, a class of diabetes medications that help the kidneys remove excess sugar through urine. Also known as gliflozins, these drugs include empagliflozin, dapagliflozin, and canagliflozin. They work by blocking a kidney transporter called SGLT2, which pulls glucose out of your blood and into your urine. But that same mechanism also pulls out water—leading to a hidden risk: dehydration.
This isn’t just about feeling thirsty. SGLT2 inhibitors can cause severe fluid loss, especially in older adults, people on diuretics, or those with kidney issues. You might not even realize it’s happening because your blood sugar can stay normal—even as your body dries out. That’s why doctors call it euglycemic DKA, a dangerous form of diabetic ketoacidosis that occurs without high blood sugar. It’s rare, but deadly if missed. Symptoms include nausea, vomiting, confusion, fatigue, and rapid breathing. If you’re on one of these meds and feel off, don’t wait for high blood sugar to sound the alarm.
People taking SGLT2 inhibitors are also more likely to get urinary tract infections or yeast infections, which can make dehydration worse. And if you’re sick, fasting, or cutting carbs, your risk goes up. Even a short bout of vomiting or diarrhea can push you into crisis. That’s why it’s critical to drink fluids consistently—not just when you’re thirsty. Avoid alcohol and heavy exercise in hot weather. Talk to your doctor before stopping these meds, even for a day. Some patients need to pause them before surgery or during illness.
These drugs are effective for weight loss and heart protection in type 2 diabetes, but they’re not risk-free. The FDA has issued warnings, and real-world cases show that dehydration from SGLT2 inhibitors is under-recognized. Many patients assume their blood sugar is the only thing to monitor. It’s not. Your fluid balance matters just as much.
In the posts below, you’ll find real-world guidance on how these medications interact with other drugs, what symptoms to watch for, how to adjust your routine, and when to call for help. Whether you’re a patient, caregiver, or health professional, these articles give you the practical details you won’t find in a drug label. No fluff. Just what you need to stay safe while using SGLT2 inhibitors.
SGLT2 inhibitors help lower blood sugar, protect the heart, and slow kidney disease - but they can cause dehydration, dizziness, and low blood pressure. Learn who’s at risk and how to manage these side effects safely.