Post-transplant diabetes mellitus (PTDM) develops in a significant number of patients due to immunosuppressive drug toxicity and additional underlying factors, leading to clinical consequences such as graft failure, infection, cardiovascular events, and mortality. There is a lack of guidance regarding optimal use of agents for glycemic control in this patient population, which requires consideration of several factors such as underlying conditions, immunosuppressive regimen, etc. Additionally, adjustment of immunosuppression for management of PTDM is observed in practice despite lack of a clear recommendation or demonstrated safety.