Abstract
The reported prevalence of post-transplantation diabetes in liver transplant recipients ranges from 9% to 31%. However, no previous study has investigated if living with a transplanted liver is associated with increased odds of diabetes, when adjusting for several known confounders. In this cross-sectional study, we included 490 liver transplant recipients at least 3 months after transplantation from the Danish Comorbidity in Liver Transplantation study (DACOLT), and 1,960 age- and sex-matched controls from the Copenhagen General Population Study (CGPS). Diabetes was defined as HbA1c ≥ 48 mmol/mol, random plasma glucose ≥ 11.1 mmol/L, self-reported diabetes and/or antidiabetic treatment. In a multivariable model, living with a transplanted liver was associated with an 8.6-fold (95% CI 6.2, 12.1; P < 0.001) increased odds of diabetes. Among liver transplant recipients and controls receiving antidiabetic treatment, 35.4% (n = 29) and 44.6% (n = 25), respectively, exceeded the HbA1c treatment threshold of 52 mmol/mol, P-value = 0.36. Within liver transplant recipients, risk factors associated with post-transplantation diabetes included previous rejection (OR 2.4; 95% CI 1.1, 5.1; P = 0.03). In conclusion, living with a transplanted liver was associated with nine-fold increased odds of diabetes. Greater clinical awareness of the diagnosis and management of post-transplantation diabetes in liver transplant recipients is clinically important and may improve patient outcomes.
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Acknowledgements
We thank all the study subjects for their participation. We also thank the staff at the Department of Surgical Gastroenterology, Rigshospitalet; the Department of Hepatology and Gastroenterology, Aarhus; the Departments of Gastroenterology in Odense, and Aalborg; and the Department of Radiology, Rigshospitalet, for their dedicated participation.
Currently employed by Novo Nordisk Denmark A/S, Copenhagen, Denmark; the present work was done independently from this employment.
Funding
This study received financial support from Svend Andersen Foundation, Kirsten and Freddy Johansens Foundation, Arvid Nilssons Foundation, Aase and Ejnar Danielsens Foundation, and the Research Foundation of University Hospital Odense and Copenhagen University Hospital – Rigshospitalet. Neither of these institutions may gain or lose financially as a result of the publication.
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NA, NAS, AB, BGN, NKA, ADF, PHF, JH and AR have no conflicts of interest to declare. JH has received a research grant from the Research Council at Rigshospitalet. DLM reports lecture fees from Takeda. SA reports a travel grant from Abbott. TA holds stock in Novo Nordic. TV is currently employed by Novo Nordisk A/S, Denmark; the present work was done independently from this employment, and has served on scientific advisory panels, been part of speakers’ bureaus, served as a consultant to and/or received research support from Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Gilead, GSK, Mass Medicine, Mundipharma, MSD/Merck, Novo Nordisk, Regor, Roche, Sanofi, Sun Pharmaceuticals and Zealand Pharma. SDN has received grants from the Research Council at Rigshospitalet, Sofus Carl Emil Friis and Wife Olga Doris Friis Scholarship, Svend Andersen Foundation, Kirsten and Freddy Johansen’s Foundation, Arvid Nilsson’s Foundation, Aase and Ejnar Danielsen’s Foundation, and the Research Foundation of University Hospital Odense and Copenhagen University Hospital – Rigshospitalet and honoraria from Gilead and MSD and has served on advisory boards for Gilead, MSD, and GSK.
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Høgh, J., Arentoft, N., Schultz, N.A. et al. Living with a transplanted liver is associated with diabetes. Sci Rep (2026). https://doi.org/10.1038/s41598-026-49938-6
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DOI: https://doi.org/10.1038/s41598-026-49938-6
