How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?   

I would first determine if there are other medications the patient is on that reduce the blood glucose. Hypoglycemia with SGLT-2 inhibitors is usually due to something else. Another medication is most likely. Could be very poor dietary intake. Could lower the dose if not on the lowest available dose...

No, SGLT2 inhibitors on their own do not typically cause hypoglycemia because their action of lowering blood sugar is dependent on the blood glucose level itself. However, the risk of hypoglycemia increases significantly when an SGLT2 inhibitor is taken with other diabetes medications that do cause ...