Synjardy 50mgs with 2000mgs of metformin

[Lisa5]

Hi.
My Synjardy has been increased from 20mgs once a day to 50mgs. It seems a lot and now I've developed a kidney infection with a small amount of ketones. I was fine on tje 20mgs dose.
Anyone managing 50mgs of Synjardy and 2000mgs of metformin without any side effects please?

 

[Antje77]

Hi.
My Synjardy has been increased from 20mgs once a day to 50mgs. It seems a lot and now I've developed a kidney infection with a small amount of ketones. I was fine on tje 20mgs dose.
Anyone managing 50mgs of Synjardy and 2000mgs of metformin without any side effects please?

Synjardy is a combination of empagliflozin and metformin.
Flozins make you pee out glucose, and make you more prone to UTI's.

Are you following a very low carb/keto type of diet?
There is a rare connection between flozins (SGLT2 inhibitors) and diabetic ketoacidosis (DKA), even without high blood glucose. Is this why you were prescribed a means to test for ketones?

Have you had any advice on what to do if you have ketones?
I would likely call 111 for advice if I saw ketones on a flozin.

 

[Lisa5]

Thank you. I wasn't prescribed anything to check my ketones. I purchased urine dip sticks myself after my last kidney infection.
I'm on a low carb diet but intermittently go over my carb allowance.

 

[EllieM]

Thank you. I wasn't prescribed anything to check my ketones. I purchased urine dip sticks myself after my last kidney infection.
I'm on a low carb diet but intermittently go over my carb allowance.

Does your team know you are low carbing, and what is your allowance.?

In New Zealand they recommend that people taking flozins don't eat keto because of the DKA risk

https://www.pinnaclepractices.co.nz/assets/Position_Statement_on_Ketogenic_or_Very-Low-Carbohydrate_Diets_and_the_Use_of_SGLT2-inhibitors_in_Adults_with_Type_2_Diabetes.pdf