Korean J Nephrol.  1999 Jan;18(1):194-197.

Diabetic Ketoacidosis after Steroid Administration for Minimal Change Disease

• Shin MJ
• Kim YO
• Park JM
• Bok HJ
• Song KH
• Yoon SA
• Bang BK

Abstract

Although diabetic ketoacidosis is relatively common in primary diabetes mellitus, it is very rare in diabetes mellitus secondary to steroid therapy. We here present a case of diabetic ketoacidosis after steroid administration for minimal change nephrotic syndrome. A 29-year-old man was first admitted with generalized edema and massive proteinuria. He had no past history of diabetes mellitus. Kidney biopsy revealed minimal change disease and he was treated with prednisolone(1mg/kg). Eight weeks after steroid treatment, proteinuria disappeared completely and steroid dose was decreased by 10mg in a week. Nine weeks after steroid treatment, diabetes mellitus newly develped and it was well controlled with insulin therapy. As prednisolone dose was decreased, insulin requirement also diminished. When he was taking 30mg of prednisolone, insulin therapy was stopped because of good glycemic control. He complained of vomitting and abdominal pain, and tachypnea a week after withdrawl of insulin. Laboratory findings revealed severe diabetic ketoacidosis. Steroid was stopped and he was treated with fluid, insulin and potassium. Now he is beibg successfully treated with 20 unit of NPH insulin without relapse of nephrotic syndrome.

Keyword

Steroid; Diabetic ketoacidosis; Minimal change disease

MeSH Terms

Abdominal Pain
Adult
Biopsy
Diabetes Mellitus
Diabetic Ketoacidosis*
Edema
Humans
Insulin
Insulin, Isophane
Kidney
Nephrosis, Lipoid*
Nephrotic Syndrome
Potassium
Prednisolone
Proteinuria
Recurrence
Tachypnea
Insulin
Insulin, Isophane
Potassium
Prednisolone