Diabetogenic effect of immunosuppressive drugs

Abstract

Many immunosuppressive drugs to show either experimental or clinical effects on glucose metabolism and regulation. These can arise from either a direct toxic effect on islet beta cells, or an indirect effect, such as insulin resistance. The problem of immunosuppression-induced diabetes is clinically relevant because patients may develop long-term degenerative complications related to glucose intolerance or suffer a deterioration of their quality of life resulting from a need for insulin injections and strict diet, an unexpected restriction in a transplanted patient with a functional organ. Disorders of glucose metabolism may also enhance complications induced by some other metabolic abnormalities found in transplant recipients, such as atherosclerosis and disorders in lipid metabolism. The diabetic state can decompensate or accelerate cardiovascular complications, which is a leading cause of patient death after transplantation.