Abstract

We report a case of a 66 year old insulin-treated Type 2 diabetic patient who developed a rapid onset nephrotic syndrome, with evidence of diabetic nephropathy in the renal biopsy. The absence of proteinuria preceding the illness and the spontaneous resolution of the nephrotic syndrome and renal failure pointed to a non-diabetic aetiology. The case illustrates the need to consider this in all patients with diabetes, nephrotic syndrome and renal failure, particularly when the presentation is atypical. This case also illustrates the reduction in exogenous insulin requirements in renal impairment.