J Korean Geriatr Soc.  2015 Mar;19(1):34-39. 10.4235/jkgs.2015.19.1.34.

Hyperinsulinemic Hypoglycemia Caused by Acute Reduction of Renal Function on an Eldery Patient Without Diabetes

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. lekang@hanyang.ac.kr

Abstract

In patient with renal failure, hypoglycemia may develop because of decreased caloric intake, diminished renal insulin degradation and clearance, reduced renal gluconeogenesis and hepatic glucose production, impaired release of counter-regulatory hormone such as glucagon and epinephrine. We report here on a 80-year-old female patient with hypoglycemia due to endogenous hyperinsulinemia with acute kidney injury. She had chronic kidney disease and had no history of diabetes mellitus or insulin use. She had experienced recurrent hypoglycemia despite of intravenous dextrose injection and eventually generalized tonic clonic seizure occurred as a result of hypoglycemia. As serum creatinine level decreases, serum insulin and C-peptide level decreased and hypoglycemia was not occurred. We present this case along with a review of the literature.

Keyword

Acute renal injury; Hypoglycemia; Hyperinsulinemia

MeSH Terms

Acute Kidney Injury
Aged, 80 and over
C-Peptide
Creatinine
Diabetes Mellitus
Energy Intake
Epinephrine
Female
Glucagon
Gluconeogenesis
Glucose
Humans
Hyperinsulinism
Hypoglycemia*
Insulin
Renal Insufficiency
Renal Insufficiency, Chronic
Seizures
C-Peptide
Creatinine
Epinephrine
Glucagon
Glucose
Insulin
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