 For the person with diabetes, renal function is a crucial factor in determining long-term outcome, and calcineurin inhibitors (tacrolimus and ciclosporin) are significantly nephrotoxic.Thus, while some people with a pancreas transplant tolerate the immunosuppressive agents well, and for such people diabetic nephropathy can gradually improve, in other people the net effect (decreased risk due to the improved blood glucose control, increased risk from the immunosuppressive agents) may worsen kidney function.Indeed, Ojo et al.