Hecking M et al concluded that DM is more among LT patients as compared to general population14 It is primarily due to post LT medications including steroids, calcineurin inhibitors (CNI), and mTOR inhibitors like sirolimus, which can induce increased glucose output and reduction in insulin production and its sensitivity.15 This new onset DM in post-transplant setting is associated with higher long-term mortality especially if not well controlled, moreover its management is also challenging due to continuation of medications responsible for its development.16 Here, INS is linked to diabetes mellitus.