In KTRs with diabetes, GLP-1 RAs and SGLT2is improved cardiometabolic outcomes without compromising graft function. Findings published in Diabetology assessed the real-world safety and effectiveness of these therapies in individuals with T2DM and post-transplant diabetes mellitus (PTDM).

This retrospective longitudinal cohort included 141 adults with diabetes after kidney transplantation (T2DM: 52; PTDM: 89) who initiated therapy between August 2013 and April 2024. The mean treatment exposure was 2.4 years. Investigators evaluated metabolic markers, medication use, renal function, and adverse events from baseline to end of follow-up.

Overall, 69% received SGLT2is and 59% received GLP-1 RAs; 28% received both. Treatment was associated with significant reductions in body weight and BMI in both diabetes subgroups. Hemoglobin A1c improved more notably in T2DM than in PTDM. Lipid parameters and blood pressure improved, and renal allograft function remained stable throughout follow-up.

Therapies were well tolerated, with mild urinary tract infections and nausea reported. There were no cases of acute rejection or severe hypoglycemia.

These results support the effectiveness and safety of GLP-1 RAs and SGLT2is across the diabetes spectrum in transplant recipients, offering cardiometabolic benefits without adverse impact on kidney graft health.