Application progress of glucagon-like peptide-1 receptor agonist in post kidney transplantation diabetes mellitus

Post transplantation diabetes mellitus (PTDM) is one of the common complications after kidney transplantation, with an incidence rate of 4% to 30%. The pharmacological treatment of PTDM after kidney transplantation faces many challenges. It is necessary to consider not only the blood glucose-lowering efficacy of the drugs themselves, but also the impact of the drugs on the function of the transplant kidney. At the same time, the interaction between antihyperglycemic drugs and immunosuppressive agents should be taken into account. Glucagon-like peptide-1 receptor agonist (GLP-1RA) have been widely used for blood glucose control in patients with type 2 diabetes mellitus. Some GLP-1RA can also improve the renal and cardiovascular outcomes of patients, and they have multiple metabolic benefits, such as improving the lipid profile and reducing body weight. Clinical studies have suggested that GLP-1RA can be used for blood glucose control in kidney transplant recipients with PTDM, with multiple benefits, including reducing the risk of kidney disease and adverse cardiovascular events, as well as improving metabolism. Moreover, no influence of GLP-1RA application on the blood concentration of immunosuppressive agents in kidney transplant recipients with PTDM has been found. Given the good application potential of GLP-1RA in the treatment of kidney transplant recipients with PTDM, this article reviews the current status and future prospects of GLP-1RA treatment for PTDM, analyzes the effects of different GLP-1RA, and explores their potential mechanisms of action in renal protection and multiple metabolic benefits, providing a basis for clinical application.