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.

dx.doi.org/10.2337/dc09-0280, hdl.handle.net/1765/25424
Diabetes Care
Erasmus MC: University Medical Center Rotterdam

Kumaraguru, J, Flanagan, S.E, Greeley, S.A.W, Nuboer, R, Støy, J, Philipson, L.H, … Rubio-Cabezas, O. (2009). Tooth discoloration in patients with neonatal diabetes after transfer onto glibenclamide: A previously unreported side effect. Diabetes Care, 32(8), 1428–1430. doi:10.2337/dc09-0280