Gliquidone therapy of new-onset diabetes mellitus after kidney transplantation

Background: New-onset diabetes mellitus (NODM) in renal transplant recipients is a complication associated with an increased long-term morbidity and mortality. However, classic sulphonylureas have not been studied in transplanted patients to date. The purpose of this study was to investigate the use of gliquidone in NODM after renal transplantation. Methods: 47 Caucasian patients with NODM received gliquidone therapy (dose range 15 - 105 mg/d) and were followed for at least 6 months. Controls receiving rosiglitazone (n = 28) were chosen for comparison. Successful treatment was defined as a significant improvement of fasting blood glucose (FBG) concentrations, and HbA1c < 7% in the absence of glucosuria, and without the need for further antidiabetic agents. Results: 29 of the 47 patients were successfully treated with gliquidone. Mean FBG improved from 154 ± 62 mg/dl to 120 ± 30 mg/dl (p = 0.002). The success rate was similar in both groups (62 vs. 71%, p = 0.39). In 4 patients the initial daily dose of gliquidone had to be decreased due to symptoms of hypoglycemia. Pretreatment with other oral antidiabetics could be identified as a negative prognostic factor. Conclusions: The data of our retrospective database study suggest that gliquidone is a safe and effective treatment option for NODM. In comparison to rosiglitazone, gliquidone has shown similar efficacy.