Table 1.

Characteristics, Metabolic Profile, and Changes with SGLT2 Inhibitors.

	Case 1	Case 2
Sex, age (y)	Female, 78	Male, 73
Comorbid conditions	Type 2 diabetes, transcatheter sapien aortic valve replacement for severe aortic stenosis, atrial fibrillation, hypertension, chronic constipation	Type 2 diabetes, benign prostate hypertrophy, dyslipidemia, hypertension, and gastroesophageal reflux disease
Therapy for hypomagnesemiaa	Maximum tolerated oral magnesium, intravenous MgSO4 4 to 6 grams weekly	Maximum tolerated oral magnesium, multiple ED visits requiring intravenous MgSO4
SGLT2 inhibitor	empagliflozin 10 mg/day	empagliflozin 12.5 mg/day

	Pre-Empagliflozin	Post-Empagliflozin	Pre-Empagliflozin	Post-Empagliflozin
HbA1c (%)	9.5	8.5	7.7	7.6
PTH (pg/mL)	40	63	37	NA
25-hydroxy vitamin D (ng/mL)	38	31	43	NA
Calcium (mg/dL)	9.2	9.4	9.4	9.5
Albumin (mg/dL)	4.0	4.2	3.9	NA
Creatinine (mg/dL)	0.80	0.98	1.2	1.2
24-hour urine Mg2+ (mg)	56	128	80	88
FEMgb	4.62%	8.37%	5.05%	4.27%

Note: FEMg was calculated as 100 × (uMg × sCr)/(0.7 × sMg × uCr), where uMg and uCr represent urinary magnesium and creatinine concentrations measured in 24-hour urine collections, and sMg and sCr represent serum magnesium and creatinine levels, respectively.

Abbreviations: ED, emergency department; HbA1c, hemoglobin A1c; MgSO₄, magnesium sulfate; NA, not available; PTH, parathyroid hormone; SGLT2, sodium-glucose cotransporter 2.

^aDetails of medications present during 24-hour urine collections can be found in Table S1.

^bDetails of 24-hour urine study calculations of creatinine clearance, fractional excretion of magnesium (FEMg), and the filtered load of magnesium, pre-SGLT2 inhibitor use and post-SGLT2 inhibitor use can be found in Table S2.