Patients with diabetes who are new to taking SGLT2 inhibitors may wonder about the side effects of Jardiance.

Jardiance, made by Boehringer Ingelheim and Eli Lilly, was approved by the Food and Drug Administration (FDA) in August 2014. Jardiance belongs to a class of drugs called SGLT2 inhibitors, which is short for sodium-glucose co-transporter 2 inhibitors.

Basically, Jardiance and other drugs in its class work to reduce blood sugar (glucose) levels by redirecting the excess sugar away from the bloodstream and out through the urine.

What are the Side Effects of Jardiance?

Because of that redirection of sugar out the urine, the patient taking Jardiance will experience more frequent urination. As a result, patients may become dehydrated, which can lead to a host of other issues, especially because patients are already battling the ravages of diabetes.

When the body becomes dehydrated, the blood thickens because there is less moisture to keep it moving fluidly through all the veins, arteries and blood vessels. The diabetes disease already interferes with proper circulation. Dehydration further impairs circulation, which means blood might not properly flow to the ends of the feet and toes, placing them at risk of gangrene, infection and ultimately, amputation.

Peter Ueda, MD, Ph.D. of Karolinska University Hospital in Stockholm, Sweden led a study that found an increased risk of lower limb amputations, especially of the middle of the foot and toes, among patients taking SGLT2 inhibitors, including Jardiance, Farxiga, and Invokana.

Patients on these SGLT2 inhibitors were at more than twice the risk of amputation compared to patients who took a GLP1 receptor agonist instead. (GLP1 receptor agonists include Byetta/Bydureon which is exenatide and Victoza, Saxenda, which is liraglutide.)

Ueda and his team of researchers analyzed information from Swedish and Danish health databases for the years 2013 to 2016 and found that patients who had a history of circulation problems, including PAD (peripheral arterial disease) and those who had previously undergone amputation of a lower limb were particularly at risk.

Overweight men who were insulin-dependent or using a DPP-4 (dipeptidyl peptidase-4) also experienced an increased risk of amputation when taking an SGLT2 inhibitor such as Jardiance.

The study by Ueda’s team confirmed the findings of the CANVAS Program, which consisted of data from two clinical trials involving 10,142 patients who were diagnosed with type-2 diabetes and higher than average risk of cardiovascular issues. The CANVAS studies determined that patients who were treated with an SGLT2 inhibitor had a lower risk of cardiovascular events, but a higher risk of amputation of the toe or middle of the foot.

What are the side effects of Jardiance, other than an increased risk of amputation? Patients also may contract serious urinary tract infections, change in kidney function, nausea/vomiting, or a vaginal yeast infection. Low blood sugar is a possible side effect if Jardiance is prescribed in combination with other medications to treat diabetes, if not enough calories are consumed or if the patient participates in excessively heavy exercise.