This work intended to test the association of Angiotensin Converting Enzyme (ACE) gene insertion (I) and Deletion (D) polymorphism in the End Stage Renal Disease (ESRD) subjects who developed post-transplant diabetes mellitus (PTDM) on using immunosuppressive drugs from an Asian Indian population. ACE is known to play an important role in the adaptation and regulation of systemic and renal circulations through angiogenesis II formation and kinins metabolism. A total of 240 non-diabetic ESRD individuals were prospectively screened for PTDM after renal transplant and 42 (30%) patients developed PTDM, whereas remaining 98 (70%) patients were non-PTDM. Genomic DNA was isolated from all the subjects and genotyping was performed for I28005D polymorphism using PCR-based assay. Individuals with PTDM had a higher DD (33.3%) genotypes and D (0.51) allele compared to controls. There was a significant difference between the genotype and allele frequencies of the PTDM cases and controls [for D Vs I, χ2=0.0244; p=0.02, odds ratio=1.98 (95% CI: 1.09-3.63; DD+ID Vs II, χ2=0.0316; p=0.03, odds ratio=2.9 (95% CI: 1.07-7.8)]. From our results we conclude that ACE gene polymorphism has role and a conventional risk facto
r in developing the disease in PTDM individuals from Asian Indian population.