SAFETY AND EFFICACY OF SGLT2 INHIBITORS IN RENAL TRANSPLANT RECIPIENTS

Abstract

Objective: To evaluate the safety profile and effectiveness of Empagliflozin (SGLT 2 inhibitor) in treating PTDM (post-transplant diabetes mellitus) specifically in renal transplant recipients. Methods: This single-center randomized case-control trial was conducted in the Armed Forces Institute of Urology, Rawalpindi, from January 2025 to May 2025. Patients who underwent renal transplantation and who developed PTDM were enrolled. Group P: patients received a placebo drug daily for 20 weeks, and Group E patients received Empagliflozin for 20 weeks daily. The patients were called for regular follow-up at weeks 5, 10, 15, and 20. Fasting blood sugar (FBS), and HbA1c were noted before starting the treatment, and at each follow-up. Results: The average age of participants in Group E was 35.5±6.2 years while Group P had an average age of 34.9±7.1 years (p-value 0.75). The duration after transplantation was similar as well, with Group E reporting an average of 3.2(±1.8) years and Group P reporting 3.4 (±1.7) years (p-value 0.68). There was no significant difference in baseline HbA1c, FBS and BMI of participants. However, by week 20, FBS levels in Group E had decreased significantly to 128±6 mg/dL, compared to 137±8 mg/dL in Group P (p<0.0001). HbA1c in Group E had dropped to 6.6±0.30%, while Group P had increased to 6.9±0.31% (p=0.001). Hemoglobin levels also showed increase in group E.  Conclusion: The use of Empagliflozin significantly improves glycemic control and helps in weight reduction in patients with PTDM in renal transplant recipients.