A Case of Nephrotic Syndrome Presenting with Fasting Hypoglycemia During Treatment with Prednisolone

Abstract

A 29-yar-old man with the nephrotic syndrome presented with fasting hypoglycemia (40~50 mg/dl) and hyperinsulinemia during treatment with prednisolone. Daily profiles of plasma glucose and insulin, and a 75 g oral glucose tolerance test revealed mildly abnormal glucose tolerance and hyperinsulinemia. A C-peptide suppression test showed that the C -peptide level was reduced from 3.3 to 1.2 ng/ml. An abdominal CT examination revealed diffuse enlargement of the pancreas without any abdominal mass. The fasting plasma glucose level increased to normal as the dose of prednisolone was decreased. No symptoms of hypoglycemia have been observed during the 8-year follow-up period. The fasting glucose and insulin levels remain normal. Therefore, the fasting hypoglycemia with hyperinsulinemia in this case was probably caused by treatment with prednisolone. © 1995, THE JAPAN DIABETES SOCIETY. All rights reserved.