Do SGLT2 inhibitors change what I should eat?

SGLT2 inhibitors work by making your kidneys spill glucose into urine instead of reabsorbing it. That glucose pulls water with it, so you urinate more and carry slightly less fluid — which is part of how these drugs protect the heart and kidneys.

The practical food and drink changes are modest but real: keep a steadier fluid intake, don't pair the medication with prolonged fasting or a very-low-carb diet without telling your care team (that combination raises the risk of a rare but serious ketoacidosis), and pause the drug during vomiting, diarrhea, or before surgery — the so-called sick-day rule.

Your kidney numbers may dip slightly in the first weeks. That's the drug lowering pressure inside the filters — the intended effect — not damage, and the trend usually stabilizes.