Management of diabetes after kidney transplantation remains challenging because of concerns regarding cardiovascular risk, graft outcomes, and treatment-related safety. Findings presented at the ADA Scientific Sessions 2026 evaluated the safety and efficacy of semaglutide in kidney transplant recipients (KTR) with T2DM.
This real-world analysis included 45 KTR with T2DM treated with semaglutide and followed quarterly for up to 12 months. Primary endpoints included changes in glycated hemoglobin (HbA1c) and estimated glomerular filtration rate (eGFR). Secondary endpoints included changes in body weight, safety outcomes, and treatment discontinuation rates.
Findings
- Mean age was 56.4 ± 10.3 years, and 53.3% of participants were female.
- Baseline HbA1c was 7.4 ± 1.2%, baseline eGFR was 67.8 ± 31.1 mL/min/1.73 m², and baseline body weight was 88.0 ± 17.8 kg.
- Semaglutide reduced HbA1c by 0.21% during follow-up (P=0.030).
- Mean body weight decreased by 3.35 kg with treatment (P=0.002).
- Allograft function remained stable, with no significant change in eGFR (Δ +0.62 mL/min/1.73 m²; P=0.696).
- Gastrointestinal adverse events were the most commonly reported safety events and were consistent with the known GLP-1 receptor agonist class profile.
This analysis suggested that semaglutide improved glycemic control and reduced body weight in KTR with T2DM without evidence of worsening allograft function during follow-up. Larger prospective studies are needed to further assess long-term safety and clinical outcomes in transplant populations.
