Tooth Discoloration in Patients With Neonatal Diabetes After Transfer Onto Glibenclamide
A previously unreported side effect
- Janani Kumaraguru, MBBS1,2,
- Sarah E. Flanagan, PHD1,
- Siri Atma W. Greeley, MD, PHD3,
- Roos Nuboer, MD4,
- Julie Støy, MD5,
- Louis H. Philipson, MD, PHD5,
- Andrew T. Hattersley, DM, FRCP1,2 and
- Oscar Rubio-Cabezas, MD1,6
- 1Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, U.K.;
- 2Diabetes & Endocrinology Vascular Health Centre, Royal Devon & Exeter Hospital, Exeter, U.K.;
- 3Department of Pediatrics, University of Chicago, Chicago, Illinois;
- 4Division of Diabetes, Sophia Children's Hospital, Rotterdam, the Netherlands;
- 5Department of Medicine, University of Chicago, Chicago, Illinois;
- 6Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
- Corresponding author: Oscar Rubio-Cabezas, oscar.rubio-cabezas{at}pms.ac.uk.
Abstract
OBJECTIVE To assess if tooth discoloration is a novel side effect of sulfonylurea therapy in patients with permanent neonatal diabetes due to mutations in KCNJ11.
RESEARCH DESIGN AND METHODS A total of 67 patients with a known KCNJ11 mutation who had been successfully transferred from insulin injections onto oral sulfonylureas were contacted and asked about the development of tooth discoloration after transfer.
RESULTS Altered tooth appearance was identified in 5 of the 67 patients. This was variable in severity, ranging from mild discoloration/staining (n = 4) to loss of enamel (n = 1) and was only seen in patients taking glibenclamide (glyburide).
CONCLUSIONS These previously unreported side effects may relate to the developing tooth and/or to the high local concentrations in the children who frequently chewed glibenclamide tablets or took it as a concentrated solution. Given the multiple benefits of sulfonylurea treatment for patients with activating KCNJ11 mutations, this association warrants further investigation but should not preclude such treatment.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received February 17, 2009.
- Accepted May 3, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
