Diabetes: SGLT2 inhibitors: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Diabetes: SGLT2 inhibitors

Sample item

A patient taking empagliflozin presents with nausea, abdominal pain, ketonaemia, and only mildly elevated glucose. Which adverse effect is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Euglycaemic diabetic ketoacidosis

SGLT2 inhibitors promote urinary glucose loss and can allow ketoacidosis with near-normal glucose, particularly during fasting, acute illness, or reduced insulin. Ketones must be checked despite modest glucose values.

Option by option

  • A. Hyperosmolar hyperglycaemic state

    HHS usually has profound hyperglycaemia and little ketosis.

  • B. Lactic acidosis from mitochondrial poisoning

    This mechanism describes severe metformin-associated lactic acidosis, not empagliflozin.

  • C. Euglycaemic diabetic ketoacidosis (correct)

    Correct. This is the classic atypical presentation of SGLT2-associated ketoacidosis.

  • D. Insulinoma

    An insulinoma causes hypoglycaemia, not ketonaemic acidosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Euglycaemic diabetic ketoacidosis. SGLT2 inhibitors promote urinary glucose loss and can allow ketoacidosis with near-normal glucose, particularly during fasting, acute illness, or reduced insulin.

Why is "Hyperosmolar hyperglycaemic state" not the answer?

HHS usually has profound hyperglycaemia and little ketosis.

Why is "Lactic acidosis from mitochondrial poisoning" not the answer?

This mechanism describes severe metformin-associated lactic acidosis, not empagliflozin.

Why is "Insulinoma" not the answer?

An insulinoma causes hypoglycaemia, not ketonaemic acidosis.

What concept does this question test?

It tests Diabetes: SGLT2 inhibitors in Pharmacology. Ketones must be checked despite modest glucose values.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Diabetes: SGLT2 inhibitors?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.