SGLT2 Side Effects: What You Need to Know Before Taking These Diabetes Drugs

When you take an SGLT2 inhibitor, a class of diabetes medications that lower blood sugar by making your kidneys remove excess glucose through urine. Also known as gliflozins, these drugs include dapagliflozin, empagliflozin, and canagliflozin — and while they help control blood sugar, they don’t come without risks. Unlike older diabetes pills that push your pancreas to make more insulin, SGLT2 inhibitors work differently: they let your body flush out sugar like a natural diuretic. That’s why they also help with weight loss and lower blood pressure. But this same mechanism is what causes the most common and serious side effects.

One of the biggest concerns is genital infections, fungal or bacterial infections in the urinary and genital areas caused by sugar in the urine. Also known as yeast infections, these happen in up to 1 in 10 people taking these drugs — more often in women, but men get them too. Symptoms include itching, redness, and discomfort. They’re treatable, but they’re also preventable: drink more water, keep the area clean and dry, and don’t ignore early signs. Another major issue is dehydration, a risk because your body is losing more fluid through urine. Also known as volume depletion, this can lead to dizziness, low blood pressure, and even kidney injury — especially if you’re already on diuretics, have heart failure, or don’t drink enough fluids. Some people also report increased risk of ketoacidosis, a dangerous buildup of acids in the blood, even when blood sugar isn’t extremely high. Also known as euglycemic DKA, this rare but life-threatening reaction can sneak up if you’re sick, fasting, or cutting carbs too hard. Kidney function can also drop temporarily — not because the drug breaks your kidneys, but because it changes how they filter blood. That’s why doctors check your kidney numbers before and during treatment.

These side effects aren’t theoretical. Real people on SGLT2 inhibitors report hospital visits for dehydration, emergency treatment for yeast infections, and scary episodes of ketoacidosis that started with just fatigue and nausea. But here’s the thing: most of these risks are manageable. Know the signs. Stay hydrated. Watch for unusual symptoms. Talk to your pharmacist if you’re also taking blood pressure or diuretic meds. The posts below give you real, no-fluff details on how these drugs affect your body, what to watch for, and how to avoid the most common traps — from genital infections to kidney stress — without stopping the treatment that’s helping your blood sugar.