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Updated: Jan 22, 2026
Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation
Published on: November 17, 2014
Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Solid Organ Transplant Recipients: A Systematic Review and
Min Jung Geum1, Kyung Sun Oh2, Young-Mi Ah2
1Department of Pharmacy, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea, yuhs.or.kr.
Background:
Solid organ transplant recipients with diabetes mellitus face unique challenges in glycemic control, compounded by the metabolic effects of immunosuppressants. Although sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective in diabetes, evidence for their use in transplant recipients remains limited. We aimed to systematically review the efficacy and safety of SGLT2 inhibitors in transplant recipients with diabetes.
Methods:
A systematic review and meta-analysis was conducted by searching the MEDLINE, Embase, and Cochrane CENTRAL databases for studies published before July 2025. Seventeen comparative studies involving 12,892 transplant recipients with diabetes were included. Efficacy and safety data of SGLT2 inhibitors were extracted and analyzed. A random-effects model was used to pool the results.
Results:
SGLT2 inhibitors led to a significantly greater reduction in HbA1c (mean difference [MD]: -0.59% and 95% confidence interval [CI]: -0.91 to -0.26) and body mass index (MD: -0.82 kg/m2 and 95% CI: -1.54 to -0.10) compared to controls. The risks of dialysis (odds ratio [OR]: 0.50 and 95% CI: 0.31-0.79), major adverse cardiovascular events (OR: 0.29 and 95% CI: 0.22-0.38), heart failure (OR: 0.66 and 95% CI: 0.52-0.83), urinary tract infection (OR: 0.45 and 95% CI: 0.22-0.92), graft rejection (OR: 0.73, 95% and CI: 0.64-0.83), and all-cause mortality (OR: 0.40 and 95% CI: 0.27-0.59) were significantly lower in the SGLT2 inhibitor group.
Conclusions:
SGLT2 inhibitors were associated with improved glycemic control, weight reduction, and favorable trends in cardiovascular outcomes among solid organ transplant recipients. Most safety outcomes, including urinary tract infection and graft rejection, were comparable between groups or more favorable in the SGLT2 inhibitor group, particularly among kidney transplant recipients. These findings support the use of SGLT2 inhibitors in this population. However, further large-scale studies are warranted to validate these results and assess the long-term effects across different transplant types.
Insights
Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve glycemic control and reduce cardiovascular risks in transplant recipients with diabetes. These drugs also show favorable safety profiles, supporting their use in this patient group.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Solid organ transplant recipients with diabetes face challenges in glycemic control due to immunosuppressants.
- Evidence for sodium-glucose cotransporter 2 (SGLT2) inhibitor use in transplant recipients is limited.
- This study reviews SGLT2 inhibitor efficacy and safety in this population.
Purpose of the Study:
- To systematically review the efficacy and safety of SGLT2 inhibitors in transplant recipients with diabetes.
- To evaluate the impact of SGLT2 inhibitors on glycemic control, cardiovascular outcomes, and safety.
- To provide evidence supporting the use of SGLT2 inhibitors in solid organ transplant recipients with diabetes.
Main Methods:
- Systematic review and meta-analysis of comparative studies.
- Searched MEDLINE, Embase, and Cochrane CENTRAL databases.
- Included 17 studies with 12,892 transplant recipients; analyzed efficacy and safety data using a random-effects model.
Main Results:
- SGLT2 inhibitors significantly reduced HbA1c and body mass index.
- Lower risks of dialysis, major adverse cardiovascular events, heart failure, urinary tract infection, graft rejection, and all-cause mortality were observed.
- These benefits were particularly noted in kidney transplant recipients.
Conclusions:
- SGLT2 inhibitors improve glycemic control, promote weight reduction, and offer cardiovascular benefits in transplant recipients.
- Safety outcomes, including urinary tract infection and graft rejection, were comparable or more favorable with SGLT2 inhibitors.
- Findings support SGLT2 inhibitor use, but further large-scale studies are needed to confirm long-term effects across different transplant types.
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