Tacrolimus-Induced Diabetic Ketoacidosis and Effect of Switching to Everolimus: A Case Report

Tacrolimus-associated diabetic ketoacidosis: a case report and literature review

“…BMI: body-mass-index; M: male; F: female; BM: bone marrow; TAC: tacrolimus; MPL: methylprednisolone; PDL: prednisolone; PDN: prednisone; MPS: mycophenolate sodium; MMF: mycophenolate mofetil; AZT: azathioprine; CYC: cyclosporine; RG: random glucose; FG: fasting glucose; Yr: year; Mo: month; Wk: week; NA: not available; DM: diabetes mellitus; Tx: therapy Five of the now seven reported cases detail the development of diabetic ketoacidosis at least six months after renal transplantation (2-5, 7). In contrast, our case and the case detailed by Dr. Tuğcu and his colleagues describe the presentation of DKA and new onset diabetes within three months of transplantation (6).…”

Posttransplant Tacrolimus-Induced Diabetic Ketoacidosis: Review of the Literature

“…Summary of these cases focused on clinical presentation and management is described in Table 1 . Out of the 15 cases, 6 had kidney transplant [ 8 , 10 , 13 , 16 , 17 ], 6 had liver transplant [ 9 , 12 , 13 , 18 ], 2 had heart transplant [ 11 , 14 ], and 1 had bone marrow transplant [ 15 ]. The mean age of patients was 29.9 ± 15.2 years with no gender predominance (8 females and 7 males).…”

“…Both tapering tacrolimus regimens and cyclosporine substitution for tacrolimus have been associated with decreased insulin requirements. There is one case report in which everolimus substitution for tacrolimus provided sufficient decline in insulin requirements [ 17 ].…”