Canagliflozin lowers blood glucose through urinary glucose excretion.During medication,close attention should be paid to three types of risks:genitourinary tract infections,ketoacidosis,and hypovolemia.

I.Genitourinary Tract Infections

1.Causes

Elevated sugar in urine promotes bacterial and fungal growth.

Women have a relatively higher risk of vulvar and genitourinary tract infections.

2.Common Manifestations

Frequent urination,urgency,painful urination,and lower abdominal discomfort.

Vulvar itching,increased discharge,or odor.

In severe cases,fever and back pain may occur.

3.Prevention and Management

Drink enough water daily,urinate frequently,and do not hold urine.

Keep the perineal area clean and dry.

Seek medical attention promptly if symptoms occur,and receive anti-infective treatment if necessary.

For recurrent infections,evaluate whether to continue the medication.

II.Ketoacidosis

1.Risk Characteristics

It may occur even when blood glucose is normal or only mildly elevated.

Surgery,infection,fasting,alcohol consumption,or significant insulin reduction can trigger it.

2.Warning Symptoms

Nausea,vomiting,and abdominal pain.

Fatigue,thirst,and deep rapid breathing.

Fruity breath odor and confusion.

3.Management Principles

Seek medical attention immediately if the above symptoms occur;do not delay.

Avoid extreme dieting and excessive alcohol consumption during medication.

Consult a physician about whether to suspend medication during surgery or acute illness.

III.Hypovolemia

1.Causes

Urinary glucose excretion removes water,leading to dehydration.

It is more likely to occur when combined with diuretics or antihypertensive drugs,or when food intake is reduced.

2.Common Manifestations

Thirst,fatigue,and dizziness.

Orthostatic hypotension and increased heart rate.

Significantly reduced urine output.

3.Prevention and Management

Ensure adequate water intake and avoid prolonged high-temperature environments.

In case of diarrhea or vomiting,rehydrate promptly and seek medical attention.

Elderly patients and those with renal impairment should be monitored more closely.

Adjust the medication regimen by a physician if necessary.