SGLT2 抑制劑是一類能促進尿糖排出、改善血糖與心腎保護的藥物。然而在圍手術期，這類藥物可能導致一項潛在嚴重但不常見的併發症：優糖性酮酸中毒（euglycemic diabetic ketoacidosis, eDKA）。在禁食、感染、脫水或手術應激的情境下，病人體內胰島素需求增加，而 SGLT2 抑制劑仍促使尿糖排出，進一步降低血糖水平，掩蓋傳統酮酸中毒的高血糖特徵，導致延遲診斷。圍手術期停藥建議如下：輕度或中型手術：建議手術前至少 3 天停藥（72 小時）高風險或大型手術、全身麻醉者：可考慮提前 4–5 天停藥術後需確認酮體為陰性，且病人恢復正常飲食與活動後方可恢復用藥此外，術前應詳細評估患者是否合併其他酮酸中毒風險，如低碳水化合物飲食、脫水、胰島素劑量過低等。臨床提醒： 醫療團隊應提高警覺，當術後患者有噁心、嘔吐、代謝性酸中毒但血糖不高時，應儘速檢測血酮與動脈血氣，以排除 eDKA。
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