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# SGLT2 inhibitors
- URL: https://www.preanaesthesia.com/clinician-reference/sglt2-inhibitors/
- Published: 2026-09-13T04:53:45.000Z
- Updated: 2026-09-13T19:18:54.000Z
- Description: Review interruption before scheduled surgery, perioperative ketoacidosis risk and considerations for restarting treatment.
- Author: preetam satish
- Tags: #clinician, #Import 2026-09-12 18:04

The cited ADA 2026 and AHA/ACC 2024 guidance recommends interrupting SGLT2 inhibitors before scheduled surgery: 3 days for canagliflozin, dapagliflozin and empagliflozin, and 4 days for ertugliflozin.

Perioperative ketoacidosis, including euglycaemic ketoacidosis, remains an important concern, particularly in nonelective surgery, prolonged fasting or acute illness. Decisions about restarting treatment depend on clinical recovery, nutritional intake and resolution of ketosis risk.

## Sources

- [ADA Standards of Care 2026, section 16](https://diabetesjournals.org/care/article/49/Supplement%5F1/S339/163925/16-Diabetes-Care-in-the-Hospital-Standards-of-Care)
- [2024 AHA/ACC perioperative cardiovascular guideline](https://professional.heart.org/en/science-news/2024-guideline-for-perioperative-cardiovascular-management-for-noncardiac-surgery)

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