Post-transplant diabetes mellitus (PTDM) is a major metabolic complication after kidney transplantation (1). Diabetogenic potential of tacrolimus is known to be much higher than that of cyclosporine in the early post-transplantation period (2). Tacrolimus may cause PTDM by transcriptional inhibition of the insulin gene in the β-cell, which is known to be potentially reversible (3). We report a renal allograft recipient showing complete insulin independence after severe diabetic ketoacidosis associated with tacrolimus treatment. A 35-year-old woman was admitted to the hospital via emergency room because of altered mentality. Six months before admission, she had undergone kidney transplantation for end-stage renal failure, the underlying cause of which was unknown. Immunosuppressive …