New immunosuppressive drugs and diabetes mellitus.

Glucocorticoids, calcineurin inhibitors (especially tacrolimus) and the com bination of both are responsible for the occurrence of diabetes mellitus af ter organ transplantation. These drugs induce both insulin resistance and i nsulinopenia. Risks factors are well identified: high doses of immunosuppre ssive drugs, genetic background, age and weight excess. Long-term consequen ces seem to be as deleterious as those of other types of diabetes mellitus. Modulating the doses of immunosuppressive drugs is efficient in decreasing insulin requirement in transplant recipients but only individualization of immunosuppression taking risks factors into account will permit to decreas e the incidence of this side-effect.