Dapagliflozin

Excellent! Dapagliflozin is an SGLT2 inhibitor that blocks SGLT2 in the proximal tubule, leading to increased urinary glucose excretion and mild osmotic natriuresis. This produces modest weight loss and blood pressure reduction, lowers preload, and reduces intraglomerular pressure, which contributes to kidney protection. Clinically, it reduces heart failure hospitalizations and cardiovascular death in HFrEF irrespective of diabetes status, and provides modest glucose lowering in type 2 diabetes.

The cardiologist explains that caution is needed with this drug because Mr. Green will also be taking a diuretic and therefore they will need to monitor very closely.

Endocrinology Follow-Up

The endocrinologist informs Mr. Green that his HbA1c is within the target range. He has also managed to lose 5kg. You are surprised that Mr. Green is not happier with these results as he is clearly pre-occupied with his own thoughts.

You ask him whether everything else is going well. He nods his head initially and then tells you that Rachel, his 29-year old daughter, who is about 5-months pregnant, has just been diagnosed with gestational diabetes. Mr. Green blames himself as he knows that diabetes can be passed onto your children. Dr. McPhee reassures Mr. Green that this is a common condition and many women manage it well, with no complications for the patients or the baby. He asks Mr. Green whether his daughter is taking insulin. Mr. Green replies that his daughter hates needles and is reluctant to take any shots.

Therefore her doctor recommended another drug, which she can take as a tablet.

Which drug was most likely prescribed?