 Minimization of steroid use has clear metabolic benefits for the diabetic patients. Within Stanford University Transplant service there is enough experience to support its safe use. In this study, all patients will have minimal exposure to steroids. We have opted to give only peri-operative steroids 4 doses total as in our experience this approach is associated with better initial graft function than the complete steroid avoidance. We also elected to use induction therapy with Thymoglobulin as it is associated with the lowest rate of rejection rate in the above mentioned studies.14 