Balancing the evidence with the SPAQI recommendations: from perioperative discontinuation towards continuation of SGLT2 inhibitors

The authors examine the perioperative management of sodium-glucose cotransporter 2 (SGLT2) inhibitors, questioning whether discontinuation or continuation is more beneficial for patients undergoing surgery. They highlight a risk-stratified approach that considers the potential for euglycaemic ketoacidosis versus the established cardio-renal benefits of SGLT2 inhibitors, advocating for careful metabolic monitoring rather than blanket discontinuation. The paper emphasizes the need for further research to validate these recommendations.