Dapagliflozin in Kidney Transplant Patients with Diabetes

Background: This study evaluates the clinical impact of dapagliflozin in diabetic patients following renal transplantation. Methods: This randomized controlled clinical trial was conducted on 72 stable post-renal transplantation diabetic patients, equally assigned to dapagliflozin and control .All patients received standard care , with the SGLT2i group receiving an additional 10 mg dapagliflozin. Baseline characteristics were well-balanced. After 6 months of follow-up, primary outcomes included 2-hour post-prandial levels, HbA1c, changes in mean body weight, eGFR, and the number of urinary tract infections Results: Both groups exhibited body weight reduction with the intervention group showing median weight loss of -4.00 kg, which was statistically significant than the control group which showed a median change of -0.75 kg . There was no statistically significant difference in eGFR (P=0.54) or 2-hour post-prandial levels (P= 0.25) , no recorded episodes of major hypoglycaemia.Also there was no statistically significant difference regarding attacks of urinary tract infections, drug interactions , no attacks of volume depletion, diabetic ketoacidosis or ischemic insults The use of other oral hypoglycaemic drugs decreased in the intervention group, with 64% of patients not needing them, compared to only 25% in the control group . There was also a significant downward trend in the number needed in the intervention group (P=0.08). The need for basal insulin decreased to 13.9% in the intervention group, compared to 38.9% in the control group. The intervention group showed a lower need for short-acting insulin, at 8.3%, compared to 16.7% in the control group Conclusion: SGLT2 inhibitors may be considered in managing post-transplant DM in renal transplant recipients, as they are anti-diabetic drugs with significant effects on weight reduction and glycemic control. Also they can be used to reduce the number of other oral hypoglycemic drugs and the dosage of short-acting and basal insulin. Monitoring is required, particularly for urinary tract infectionsComparison regarding number of OHG