Beers Criteria guidance on SGLT2 inhibitors includes which monitoring emphasis?

• A. Monitor for urogenital infections and ketoacidosis
• B. No special monitoring required
• C. Monitor only for hypoglycemia in all patients
• D. Monitor liver enzymes only

Answer: (A)

SGLT2 inhibitors work by increasing glucose excretion in the urine, which creates an environment that can promote urogenital infections like genital yeast infections and urinary tract infections. The Beers Criteria specifically calls attention to monitoring for these infections in older adults taking these drugs. In addition, there is a serious risk of diabetic ketoacidosis, which can occur with little or normal blood glucose in some cases, so clinicians emphasize watching for symptoms of ketoacidosis and assessing ketones when symptoms arise. Together, these monitoring priorities reflect the most clinically relevant safety signals for this drug class in older patients. Other options miss these key concerns, since hypoglycemia is less universal with SGLT2 inhibitors (especially when not on other hypoglycemia‑inducing agents) and liver enzyme monitoring is not a primary concern for this class.