Abstract

Background: Today, solid organ transplantation is considered a life-saving solution for end-stage patients. Post-transplant diabetes mellitus (PTDM) is a common complication after organ transplantation. Currently, the standard treatment is insulin therapy. This study investigates the efficacy and safety of two drugs, metformin and empagliflozin, in these patients due to the special conditions of transplant patients and the use of multiple drugs, considering the patients' preference for oral drugs and their ease of use.

Aim: To compare the safety and effectiveness of metformin and empagliflozin in PTDM patients.

Method: This study is a randomized clinical trial. 40 PTDM patients were randomized to receive either empagliflozin (10mg/day) or Metformin (500mg/day) for 90 days (1:1). Blood samples were taken from patients at baseline and at the end of treatment period to measure fasting blood sugar (FBS), glycated haemoglobin (HbA1c), post prandial glucose (PPG), blood urea nitrogen (BUN), Creatinine, alanine amino transferase(ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), Bilirubin, Albumin, Na and K.

 Results: Mean FBS was alleviated from 167 to 126,5 mg/dl in the metformin and from 174.8 to 121.6 mg/dl in the empagliflozin group. Notably, HbA1c was reduced from 7.48 to 6.89% from 7.67 to 6.84% in those groups, respectively. No significant alterations were observed regarding other measured parameters. Furthermore, no patient discontinued the treatment due to adverse effects.

Conclusion and Discussion: Both drugs seem to be safe in PTDM patients. Empagliflozin even exerted superiority in alleviating hyperglycaemia. Further large-scale clinical evaluations are needed to confirm the efficacy and safety of these drugs.