Background: Post-transplant diabetes mellitus (PTDM) can lead to significant morbidity and cardiovascular death with a functioning graft. A paucity of literature exists regarding glycemic control in solid organ transplant (SOT) recipients, including pharmacist management of PTDM.

Objective: To assess the impact of pharmacist interventions on diabetes mellitus management in a pharmacist-run PTDM clinic.

Methods: A single-center, prospective, observational study was conducted of SOT recipients aged 18 years or older who were enrolled in a pilot pharmacist-managed PTDM pharmacotherapy clinic from 01/2015 – 06/2015. Primary outcome measures included changes in hemoglobin A1c (HbA1c) and average daily self-monitored blood glucose (SMBG) readings from enrollment to at least 3 months follow-up. Secondary outcome measures included changes in pre-meal, 2-hour post-dinner, and bedtime SMBG, as well as changes in lipids and body mass index. Other secondary outcomes included incidence of hypoglycemia, non-adherence, and diabetes-related inpatient hospitalizations prior to PTDM clinic enrollment and at time of clinic discharge.

Results: Twenty-four patients were included in the final analysis of this study. Improvements were realized in markers of glycemic control, including primary outcomes, fasting SMBG, and pre-lunch SMBG. Median HbA1c decreased significantly from 8.05 [IQR 6.33 – 11.75] % at baseline to 6.45 [IQR 6.05 – 7.3] % (p = 0.0010) at last follow-up encounter. Average daily SMBG decreased significantly from a median of 191 [IQR 138 – 232] mg/dL at baseline to 125 [IQR 111 – 167] mg/dL (p = 0.0023) at the final encounter. Median fasting and pre-lunch SMBG decreased significantly from 153 [IQR 117 – 208] mg/dL at baseline to 120 [IQR 102 – 134] mg/dL (p = 0.0064) and 212 [IQR 159 – 258] mg/dL to 122 [IQR 110 – 169] mg/dL (p = 0.0161), respectively. Changes from baseline in other SMBG values, lipid levels, and BMI were not statistically significant.

Conclusion: A pharmacist-managed post-transplant diabetes clinic can significantly impact glycemic control in SOT recipients.

CITATION INFORMATION: Newland D, Edwards A, Hall R, Maxwell P. Positive Impact of a Pilot Pharmacist-Run Diabetes Pharmacotherapy Clinic in Solid Organ Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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