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Safety and effectiveness of GLP-1 receptor agonists and SGLT-2 inhibitors in liver transplant recipients with

Alessandra Mazzola1, Philippe Sultanik1, Aida Rebiha1

  • 1Sorbonne Université, Unité Médicale de Transplantation Hépatique Service d'Hépato gastroentérologie AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France.

Clinics and Research in Hepatology and Gastroenterology
|August 6, 2026
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT2is) show promise for managing diabetes in liver transplant recipients. These treatments are safe and can reduce insulin dependence, particularly for those with new-onset diabetes post-transplant.

Area of Science:

  • Transplantation Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes is a common complication following liver transplantation (LT).
  • Optimizing glycemic control in LT recipients is crucial for long-term outcomes.
  • Limited data exists on the use of novel antidiabetic agents in this population.

Purpose of the Study:

  • To evaluate the safety and effectiveness of glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose co-transporter-2 inhibitors (SGLT2is) in liver transplant recipients with diabetes.
  • To compare outcomes with conventional antidiabetic treatments.

Main Methods:

  • Retrospective, single-center study.
  • Included 41 patients treated with GLP1-RAs and/or SGLT2is post-LT.
  • Compared to a control group receiving other antidiabetic medications.

Main Results:

  • No serious adverse events were reported in the GLP1-RA/SGLT2i group; 15.0% experienced moderate, primarily gastrointestinal, side effects.
  • Higher achievement of fasting glycemia targets (80.0% vs. 55.0%, p=0.033) in the GLP1-RA/SGLT2i group.
  • Significant insulin withdrawal observed in 80.0% of patients with new-onset diabetes treated with GLP1-RAs/SGLT2is, versus 0% in the control group (p < 0.01).

Conclusions:

  • GLP1-RAs and SGLT2is appear safe and effective for managing diabetes in liver transplant recipients.
  • These agents facilitate insulin withdrawal, especially in patients with new-onset post-transplant diabetes.
  • Further prospective studies are warranted to investigate long-term effects on cardiovascular events, obesity, liver steatosis, and mortality.
Keywords:
Glucagon-like peptide-1 receptor agonistsGlycemic controlInsulin withdrawalNew-onset diabetesSodium-glucose co-transporter-2 inhibitors

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