Insulin resistance corticosteroids

Corticosteroids and CIs can impair glucose control in previously diabetic patients, as well as cause new-onset post-transplant diabetes mellitus (PTDM) in 4% to 20% of patients. Corticosteroids induce insulin resistance and impair peripheral glucose uptake, whereas CIs appear to inhibit insulin production. " TAC seems to be more diabetogenic than CSA, although recent studies have failed to show a statistical difference." " Other possible risk factors that have been identified for PTDM include ethnicity (African-American or Hispanic), age (>40 years), pretransplant diabetes status, family history, and weight. " ... 

Adverse effects of protease inhibitors are similar to those seen with reverse transcriptase inhibitors. In addition, this group of drugs causes metabolic disturbances, particularly insulin resistance and hyperglycaemia, and fat redistribution leading to raised plasma lipid levels, which increases the risk of heart disease. These effects are collectively known as lipodystrophy syndrome, which appears to be similar to what happens with long-term corticosteroid use. 

B. Corticosteroids (by decreasing peripheral Insulin resistance and promoting gluconeogenesis), glucagon (by enhanced glycogenolysis), and epinephrine (via beta-adrenergic effects) may antagonize the effects of insulin. 

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