Impact of specialised endocrinology care on metabolic control and healthcare utilisation outcomes after kidney transplantation in patients with diabetes: A 12‐month observational cohort study
Authors' conclusion
Metabolic control in the first post-transplant year showed stabilisation rather than improvement, with many recipients above cardiometabolic targets. Prospective studies should test whether earlier, protocolised multidisciplinary management improves cardiovascular and graft outcomes.
Study context
- Population
- Adult kidney transplant recipients with pre-existing diabetes, first year after transplantation, at a US and a European academic centre
- Participants
- 220 recipients
- Exposure
- Endocrinology-led Endocrine Transplant Clinic vs historical standard transplant care vs standard endocrinology care
- Endocrine Transplant Clinic (ETC)n = 99
- Standard transplant caren = 81reference
- Standard endocrinology caren = 40
- Outcome
- Pre-specified outcomes: HbA1c, BMI, blood pressure and lipid levels
- Follow-up
- Baseline and 3, 6 and 12 months
Methodological detailslongitudinal, two-centre (US and European academic centres), multiple imputation with complete-case sensitivity analyses
- Longitudinal
- Two-centre (US and European academic centres)
- Multiple imputation with complete-case sensitivity analyses
Main finding
As reported in the abstract
Adjusted metabolic trajectories · 12 months
HbA1c >7% at 1 year
>50%
Body mass index (BMI) stable; meeting obesity criteria throughout follow-up
≥30%
Blood pressure did not improve; systolic hypertension (>130 mmHg) remained common
49%-77%
Observational data: associations, not effects.
Further findings
HbA1c · 3, 6 and 12 months
- HbA1c >7% at 1 year
- >50%
- HbA1c unchanged at 3 and 6 months but higher at 12 months
BMI · throughout follow-up
- Meeting obesity criteria
- ≥30%
- BMI remained stable
Blood pressure
- Blood pressure did not improve; systolic hypertension (>130 mmHg) remained common
- 49%-77%
LDL-C ≥70 mg/dL · 12 months
- Cohort 1
- 20.8%
- Cohort 2
- 63.3%
- Cohort 3
- 42.3%
- Consistent in sensitivity analyses
Original publication
Impact of specialised endocrinology care on metabolic control and healthcare utilisation outcomes after kidney transplantation in patients with diabetes: A 12‐month observational cohort study. Diabetes Obes Metab. Published 23 February 2026. doi:10.
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