Short-Term Effectiveness and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in Type 2 Diabetic Patients with Renal Transplantation: A Retrospective Study

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) provide robust cardio-renal benefits in the general population with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, kidney transplant recipients (KTRs) have been excluded from pivotal randomized trials, creating a critical data gap regarding the short-term efficacy and safety of SGLT2i in this uniquely vulnerable, high-risk group. This study investigated the short-term effectiveness of SGLT2i in glycemic management and their safety in relation to allograft function in Vietnamese KTRs with T2DM. This retrospective study included 281 KTRs with T2DM at Cho Ray Hospital, Vietnam, divided into an SGLT2i-treated group (n = 140) and a non-SGLT2i group (n = 141). Primary outcomes included changes in fasting plasma glucose (FPG), estimated glomerular filtration rate (eGFR), and creatinine levels measured at baseline and after 12 months. Potential adverse events (urinary tract infection, yeast infection, and hypotension) were also monitored. Over the 12-month period, the SGLT2i group showed a significant reduction in FPG, an effect not observed in the control group. Critically, SGLT2i use was associated with the preservation of allograft function, showing stable eGFR and creatinine levels. Furthermore, no defined adverse events were observed in the treatment group. SGLT2i are effective in achieving short-term glycemic control and demonstrate a reassuring safety profile regarding allograft function in this cohort of Vietnamese KTRs. These findings support the cautious, individualized integration of SGLT2i into the care regimen for stable KTRs with T2DM, while underscoring the urgent need for long-term randomized controlled trials to validate definitive renoprotective outcomes.