The Drug Advertisement Suggests That BoXeva Should Be Added to Metformin

The drug advertisement suggests that BoXeva should be added to metformin for the treatment of patients with type 2 diabetes mellitus. A 56-year-old woman comes to the office for follow-up.  She has a history of type 2 diabetes mellitus and hypertension.  The patient has been on metformin therapy for the past 6 months.  Despite adhering to a diabetic diet and increasing her level of physical activity, she has been unable to lose weight.  At the current visit, her blood pressure is 145/90 mm Hg, and heart rate is 72/min.  Her weight is 82 kg (180 lb) .  HbA_1c is 7.6%, and serum creatinine is 0.9 mg/dL.
The section of the drug advertisement shown does not mention side effects.  BoXeva inhibits sodium-glucose cotransporter 2 (SGLT2) , which is expressed in the proximal renal tubules.  Based on this mechanism of action, which of the following side effects would be expected for the SGLT2 inhibitor class of medications?

A) Acute inflammatory pancreatitis
B) Acute lactic acidosis
C) Angioedema
D) Flatulence and diarrhea
E) Vulvovaginal candidiasis

Correct Answer:

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