IntroductionGlycemic control is important in renal transplant receptions with diabetes. In the early post-transplant period, recovering renal function and concomitant steroids and immunosuppressants increase the risk of dysglycemia which adversely impacts allograft and patient survival. We evaluated the short-term efficacy and safety of insulin degludec in diabetic renal transplant patients in early post-transplant period in outpatient settings. Materials and methodsA real world prospective observational study in 61 diabetes patients with ESRD who underwent renal transplant and were followed up for three months at Endocrinology OPD post discharge, as per routine clinical practice. All patients received standard and individualized treatment with insulin degludec. The primary outcome was change in glycosylated hemoglobin (HbA1c) and the secondary outcomes included changes in fasting (FPG)and post-prandial plasma glucose (PPPG) levels and body weight. Safety assessments included reports of hypoglycemia and changes in serum levels of creatinine and tacrolimus. ResultsMean age and duration of diabetes of the participants were 53.17 ± 8.77 years and 14.55 ± 5.71 years, respectively. During follow up, there were significant reductions in mean HbA1c (8.11 ± 1.94% to 6.96 ± 1.33%) and FPG (220.61 ± 79.42 mg/dL to 120.00 ± 37.80 mg/dL) and PPPG (303.97 ± 105.90 mg/dL to 164.25 ± 51.10 mg/dL) levels. A total of 43 patients (70.49%) achieved HbA1c target of <7%. Serum levels of creatinine and tacrolimus also reduced significantly during follow up. No significant reductions in body weight. Nocturnal hypoglycemia was reported in five patients and no patients reported severe hypoglycemia. ConclusionInsulin degludec was effective and safe in long standing diabetes patients undergoing renal transplant. Insulin degludec was well tolerated and was effective in lowering FPG, PPPG and HbA1C in early post-transplant OPD settings.