SUN-180 Successful Use of SGLT-2 Inhibitor Dapagliflozin in Three Patients with Renal Transplant and Diabetes: A Fruit for Thoughts

Background: Management of patients with diabetes and renal transplant could be challenging. Transplant patients use multiple immune suppressants; most of them are notorious in worsening or even trigger hyperglycemia. Many of these patients have to use multiple anti-hyperglyemic agents to attain adequate diabetes control. There are no data about the use of the new class of SGLT-2 inhibitor in patients with renal transplant and diabetes. Case series: Three patients, A 53 and 56 year old men, and 47 year old lady, who are attending the Diabetes Clinic at our institution, are presented here. They were diagnosed with diabetes in 2003, 2012 and 2008 respectively. They were all counselled to be started on dapagliflozin 10mg to improve diabetes control as they were on multiple agents and not achieving targets. HbA1c for the first patient at the initiation of therapy with dapagliflozin was 8.9% (March 2018), and it dropped to 6.2% in October 2018. That for the second male patient was 8.1% (June 2017) and it was 8.3% in October 2018. The lady’s HbA1c at the start of therapy in July 2017 was 7.5% and it was 6.8% in October 2018. There was no adverse effects on renal function parameters. There was some favourable effect on weight and blood pressure. None of the patients developed genitourinary infection. Conclusion: Use of the SGLT-2 inhibitor dapagliflozin in the standard dose of 10mg helped three renal transplant patient with diabetes to achieve satisfactory control and it also had favourable effects on BP and weight and was no associated with any adverse effects on renal function