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Insulin Edema

Swelling (edema) And Diabetes - Swelling In The Legs, Ankles And Feet

Swelling (edema) And Diabetes - Swelling In The Legs, Ankles And Feet

Tweet Edema (known as oedema in the UK) is a build up of fluid in the body (water retention) which causes swelling. Edema commonly affects the legs, ankles, feet and wrist. Water retention is often treatable, with treatment varying depending on the cause. Symptoms of edema The main symptom of edema is swelling of the affected area. Other symptoms that may occur, along with swelling, include: Weight gain Aching limbs Stiff joints Discolouration of skin Hypertension (high blood pressure) What causes swelling in the legs, feet and ankles? Swollen ankles and legs will often be brought on, or aggravated, by long periods of standing. A number of medications can increase the risk of oedema. Such medications include corticosteroids, blood pressure medications and the contraceptive pill. Water retention may also be caused by a number of conditions including: A high intake of salt can increase the problems of swelling in people with kidney disease. Treatment for edema Treatment for edema may vary depending on the cause. Water retention may be resolved if the underlying cause can be adequately treated. Regular physical activity and preventing long periods of standing can help reduce water retention. A low dietary salt intake is advisable, particularly if fluid retention has been brought on by kidney disease. If you are overweight, weight loss can help with reducing fluid retention. Diuretics, also known as ‘water tablets’, help to remove fluid from the body and may be prescribed for some causes of oedema. Prevention You can reduce your risk of edema by taking steps to prevent kidney disease and heart failure from developing. This can be achieved through good control of blood glucose levels, regular exercise and a healthy diet. If you can avoid long periods of standing, this wi Continue reading >>

Insulin Edema – A Rare Presentation.

Insulin Edema – A Rare Presentation.

Abstract: Introduction - Insulin edema is a rare and benign complication of insulin therapy. A syndrome of unidentified origin with exclusion of all other causes of edema. It occurs in patients with either type 1 or type 2 diabetes after the introduction or intensification of insulin treatment. It is characterized by weight gain, mild to moderate edema and rarely generalized edema. Case report - A thirty two year old Caucasian female diagnosed with Type 1 Diabetes Mellitus eight years prior with an initial weight of 250lbs. She was previously on and off insulin therapy. She has not taken her insulin for five months, no hospitalization. She had a glycosylated hemoglobin of 17.4%. Subsequent course - Basal and bolus insulin was restarted and was increased on the succeeding days. There was significant improvement in her blood glucose levels. One week after insulin treatment, she noted significant swelling in her feet that ascended to her legs and abdomen. She had a significant weight gain of 60 pounds two weeks after the initiation of Insulin when she presented to the emergency department. Physical examination revealed a puffy face and bilateral lower extremity pitting edema up to the abdomen. Lung, cardiovascular and abdominal examination was normal. Treatment and Follow up - The patient was placed on a sodium and fluid restriction diet, continued her insulin and was mildly diuresed with Furosemide. Her edema significantly lessened and she lost 15 pounds on the third hospital day. The patient remained on Insulin therapy and was seen at the clinic two months later. Her weight was stable at 150lbs with no recurrence of edema. Discussion - The pathogenesis of insulin edema involves two effects of insulin treatment – anti-natriuresis and increased capillary permeability. Fo Continue reading >>

Insulin Oedema In Newly Diagnosed Type 1 Diabetes Mellitus

Insulin Oedema In Newly Diagnosed Type 1 Diabetes Mellitus

Go to: Abstract Despite the essential role of insulin in the management of patients with insulin deficiency, insulin use can lead to adverse effects such as hypoglycaemia and weight gain. Rarely, crucial fluid retention can occur with insulin therapy, resulting in an oedematous condition. Peripheral or generalised oedema is an extremely rare complication of insulin therapy in the absence of heart, liver or renal involvement. It has been reported in newly diagnosed type 1 diabetes, in poorly controlled type 2 diabetes following the initiation of insulin therapy, and in underweight patients on large doses of insulin. The oedema occurs shortly after the initiation of intensive insulin therapy. We describe two adolescent girls with newly diagnosed type 1 diabetes, who presented with oedema of the lower extremities approximately one week after the initiation of insulin treatment; other causes of oedema were excluded. Spontaneous recovery was observed in both patients. Conflict of interest:None declared. Continue reading >>

Insulin Edema In Type 1 Diabetes Mellitus: Report Of A Case And Brief Review Of The Literature

Insulin Edema In Type 1 Diabetes Mellitus: Report Of A Case And Brief Review Of The Literature

Dear editor, Despite the essential role of insulin therapy in the management of patients with insulin deficiency, insulin itself may lead to adverse effects such as hypoglycemia and weight gain (1, 2). Additionally, crucial fluid retention can also occur rarely, resulting in an edematous condition. Peripheral or generalized edema is an extremely rare complication of insulin therapy, which mostly occurs after the initiation of intensive insulin therapy (3, 4). Here we report a 12-year-old boy with newly diagnosed type 1 diabetes, presented with edema of the lower extremities about one week after the initiation of insulin therapy with a brief review of the literature. A 12-year-old boy was admitted to the hospital with an acute presentation of DKA. In his history, polyuria and polydipsia were present for two months with a recent weight loss of 4 kg. No family history of diabetes was reported. On physical examination, his height was 152 cm (-0.31 SD) and weight was 30 kg (-1.75 SD), body mass index was 13 kg/m2 (P < 3), heart rate was 110 minutes, blood pressure 100/70 mmHg. He had somnolance, mild dehydration, and “Kussmaul” breathing. Findings of other systems on examination were within normal range. Laboratory findings; blood glucose level was 800 mg/dL, ketonuria with acidosis was present with venous blood pH of 7.0. HbA1c level was 16% (normal range 4% - 6%). He was initially treated with intravenous insulin infusion and isotonic saline (in 5% dextrose). After completing intensive DKA treatment, subcutaneous regular insulin treatment was started for determination of daily insulin requirement. And then it was switched to intensive insulin regimen as fast acting insulin (insulin lispro) before meals and insulin glargine at bed time with a total daily insulin require Continue reading >>

Insulin Resistance & Edema

Insulin Resistance & Edema

Insulin Resistance Insulin resistance is a medical condition where the cells do not absorb sufficient amounts of glucose from the bloodstream, which in turn leads to constant high blood sugar levels. Insulin resistance very often occurs with obesity, high cholesterol, and high blood pressure. This package of health conditions is often referred to as “metabolic syndrome”, and is a major risk factor for kidney failure and heart disease. Edema Edema is a condition where the legs and feet swell, and is usually a symptom of kidney failure, and may result due to obesity. Edema is due to an abundance of fluids that build up under the skin within the soft tissue. Edema can be caused by things like organ failure, varicose veins, and an inactive lifestyle. Edema and Kidney Failure Kidney failure can often be a side effect of obesity and insulin resistance, and the result can be that the things like protein is not filtered properly and the salt levels in the body may become imbalanced. When the salt levels are too high, the body starts retaining water and it may cause edema. Suggested Treatment Try to eliminate carbohydrates as far as possible from your diet, especially refined carbohydrates (see the Manna Diet) Take the Manna Blood Sugar Support supplement with each meal to help control blood glucose levels and to help reduce insulin levels. Make sure to drink at least 1.5 liters of water each day. Try to exercise at least 3 times a week, but consult with your medical practitioner before exercising if you struggle with obesity or insulin resistance. As people with edema generally suffer with acidity, we also recommend the Manna PH Balance to excrete excess uric acid from the body. Continue reading >>

Insulin Edema In The Twenty-first Century: Review Of The Existing Literature.

Insulin Edema In The Twenty-first Century: Review Of The Existing Literature.

Abstract Generalized insulin edema, although rare, is a well-recognized complication of insulin therapy. It is mainly appreciated in patients with newly diagnosed or poorly controlled diabetes mellitus after starting intensive insulin therapy. Although the condition is self-limiting, progression to overt cardiac failure and development of pleural effusion have been reported. With current trends toward intensive insulin therapy, clinicians should be aware of the existence of the insulin edema syndrome, and its occurrence should be documented and differentiated from other causes of edema. In this article, we present a recent case that illustrates the clinical features of insulin edema. Specifically, a young male with newly diagnosed type 1 diabetes mellitus developed significant, reversible peripheral edema after starting insulin therapy. A detailed case description is accompanied by the only known published photographs of insulin edema. The overall purpose of this article is to review the scanty existing medical literature surrounding the topic of insulin edema and to raise awareness about its continued occurrence. Continue reading >>

Case Report: Insulin Edema And Acute Renal Failure

Case Report: Insulin Edema And Acute Renal Failure

Generalized edema due to insulin is a rare phenomenon. We report a 35-year-old woman with newly diagnosed type 1 diabetes who presented with generalized edema, serous effusions, and acute renal failure a few hours after starting insulin. The patient presented with diabetic ketoacidosis after a 12-month history of polydipsia and polyuria. She had lost 2 kg over a 2-month period and weighed 47 kg, BMI 18 kg/m2. Blood pressure was 131/84 mmHg. Clinical examination showed Kussmaul dyspnea, but was otherwise normal. Biological findings were consistent with severe diabetic ketoacidosis: pH 6.80, bicarbonate 1.4 mmol/L. Plasma glucose was 23 mmol/L and HbA1c 13.3% (122 mmol/mol). Serum creatinine concentration was 90 μmol/L. The patient received a total of 15 L of intravenous fluids over a 96-h period. Insulin therapy was started at a rate of 8 units/h. Subcutaneous insulin was initiated on the second day, total daily dose 30 units. From the second day on, serum creatinine concentration began to increase, up to 253 μmol/L; estimated glomerular filtration rate 18 mL/min, accompanied by generalized edema. A computed tomography scan, performed when serum creatinine concentration and body weight had already started to increase, showed bilateral pleural effusions and abundant peritoneal effusion. The morphology of the kidneys was normal, and there was no sign of obstruction. A sample of pleural fluid was obtained; protein concentration was 19 g/L. At day 5 the patient had gained 16 kg, the serum creatinine concentration was 260 μmol/L and serum albumin concentration was 22 g/L. Furosemide was started, 80 mg/day. Both body weight and serum creatinine concentration immediately started to decrease and returned to baseline within a couple of days. At day 30, body weight was 54 kg an Continue reading >>

[insulin Edema In Hepatic Glycogenosis].

[insulin Edema In Hepatic Glycogenosis].

Abstract Hepatic glycogenosis is a rare syndrome, which includes poorly controlled diabetes mellitus, hepatomegaly, delayed puberty, and growth delay. Insulin edema is sometimes associated.An 18-year-old woman presented with diffuse edema, hepatomegaly, amenorrhea, uncontrolled diabetes, and elevated transaminases and cholestasis. Hepatic ultrasonography and abdominal computed tomographic scan confirmed the hepatomegaly. The liver biopsy showed a massive glycogenosis and the diagnosis of hepatic glycogenosis was confirmed. Too large doses of insulin were responsible of diffuse edema. Diabetes equilibration and diminution of insulin intakes allow correction of this disorder.Excess of insulin can lead to excessive hepatic glycogen storage by activation of glycogenosis enzymes. Biological manifestations consist on elevated liver enzymes and hyperlactatemia. There is a link between administration of high dose of insulin and edema. Hepatic glycogenosis should be suspected when diabetes is uncontrolled and be considered as a differential diagnosis of steatosis. It may be associated and revealed by insulin edema directly related to excessive insulin intakes. Continue reading >>

Insulin Edema In Diabetes Mellitus Associated With The 3243 Mitochondrial Trnaleu(uur) Mutation; Case Reports

Insulin Edema In Diabetes Mellitus Associated With The 3243 Mitochondrial Trnaleu(uur) Mutation; Case Reports

Abstract We encountered a patient with diabetes mellitus due to the 3243 mitochondrial tRNA mutation(DM-Mt3243), who developed insulin edema and hepatic dysfunction after starting insulin. Such a rare phenomenon was unlikely to be a fortuitous coincidence in mitochondrial diabetes, as none in 197 non-mutant NIDDM patients had same episode. Moreover, similar leg edema was noticed in another DM-Mt3243 patient, and other two DM-Mt3243 patients had leg edema which responded to coenzyme Q10. These observations suggest further a role of mitochondrial function on leg edema. The mechanism of his insulin edema may involve vasomotor changes induced by the rapidly glycemic control, because our case of insulin edema had a prominent increase of strong succinate dehydrogenase reactive vessels. Alternatively, myocardial dysfunction might have produced leg edema and hepatic dysfunction, because he had subclinical myocardial dysfunction, judged by imaging with β-methyl-p-(123I)- iodophenyl-pentadecanoic acid. The third explanation is that a rapid improvement of glycemic control might have induced hepatic reoxygenation and the production of reactive oxygen species in the liver that contributed to cell damage. Thus, although we cannot draw definite conclusion, our experiences here suggest that mitochondrial dysfunction is important in the etiology of insulin edema. Continue reading >>

Natural Course Of Insulin Edema

Natural Course Of Insulin Edema

Abstract Generalized edema due to water retention is a very rare complication of insulin therapy. It affects mainly patients with newly diagnosed diabetes or patients with chronic hyperglycemia following initiation of insulin therapy. When it occurs, it is treated effectively with diuretics. This case report describes a female patient, who developed severe insulin edema following initiation of insulin. Diuretics were not given due to severe side effects, thus the natural outcome of insulin edema was observed. Edema was gradually replaced by fat tissue with persistent weight gain. Physicians treating diabetic patients should be aware of "insulin edema" in the differential diagnosis of weight gain in patients treated with insulin. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free Continue reading >>

Generalized Edema Immediately Following Insulin Control In Diabetes Mellitus

Generalized Edema Immediately Following Insulin Control In Diabetes Mellitus

A pronounced generalized edema occurring in diabetic patients immediately following desugarization of the urine with insulin therapy was observed five times last year in this clinic. The edema promptly disappeared after treatment with potassium bicarbonate and potassium chlorid, 0.6 gm. each three times a day with meals. Thus far we have found no case reports in this country of this annoying untoward effect of insulin control in diabetes. However, edema with insulin therapy has been noted in the German clinics. Hagedorn 1 explains an increase in weight of insulin patients with cessation of the diabetic symptoms as partly a water retention. Edema induced by insulin is reported by von Jaksch-Wartenhorst,2 by von Noorden and Isaac,3 and by Klein.4 It may be mentioned that these writers employed insulin preparations made in Europe, which may have been more effective in inducing water retention through less complete removal of proteins Continue reading >>

Insulin Edema In A Patient With Cystic Fibrosis–related Diabetes

Insulin Edema In A Patient With Cystic Fibrosis–related Diabetes

Insulin edema is a rare complication of insulin therapy primarily seen with newly diagnosed or uncontrolled diabetes (1–3). Patients at risk are those who are beginning insulin treatment, underweight, or increasing their insulin dose either in the normal course of the disease or after diabetic ketoacidosis (1,4). The prevalence of insulin edema is unknown; a review of the literature revealed few case reports of insulin edema and no reports of insulin edema in a patient with cystic fibrosis–related diabetes (CFRD). This case report illustrates the effects of insulin edema in a 23-year-old female patient who was diagnosed with CFRD at the age of 16 years. The patient presented to the pediatric endocrine clinic at the age of 16 years with an HbA1c of 9.8%. She started therapy on an insulin pump, and within 1 month, her HbA1c level fell within target range, and a lung transplant occurred in December 2007. One year later, her HbA1c increased to 11.9%, and physical exam (PE) revealed lower extremity (LE) edema to the midcalf. Three months later, her HbA1c increased to 12.5%. The patient's pump download data revealed that insulin had only been administered for 2 nonconsecutive days before her appointment. Almost 1 year after a pump re-education session (August 2009), the patient's HbA1c decreased to 11.8%. Pump download data revealed increased bolus intake as the patient's appointment neared. PE revealed nonpitting LE edema. All of the potential causes of edema were considered, including cardiac abnormalities, liver impairment, and transplant medications. Furosemide was prescribed but did not resolve the edema. Six months later, the patient's HbA1c increased to 16.5%. Consistent with prior visits, her pump download data revealed insulin delivery only on the 2 days before c Continue reading >>

Insulin Edema In A Child With Diabetes Mellitus Type 1.

Insulin Edema In A Child With Diabetes Mellitus Type 1.

Abstract Despite the essential role of insulin in the management of patients with diabetes mellitus type 1, insulin use can cause a variety of adverse effects, such as hypoglycemia and weight gain. Herein, we describe an adolescent girl with type 1 diabetes mellitus diagnosed one year ago, who presented with edema of the lower extremities approximately two weeks after an increase in the insulin dose; other causes of edema were excluded. Spontaneous recovery was observed in the patient. Links Authors Rostami P , Sotoudeh A , Nakhaeimoghadam M , , MeSH Adolescent Diabetes Mellitus, Type 1 Edema Female Humans Hypoglycemic Agents Insulin Lower Extremity Remission, Spontaneous Pub Type(s) Case Reports Journal Article Language eng PubMed ID 23094546 Continue reading >>

Edema

Edema

Abnormal accumulation of fluid in various body tissues, causing swelling. The swelling may affect any of a number of body sites, such as the legs, ankles, and feet; the hands; the back or abdomen; and even the eyelids. Edema may be caused by a number of different medical conditions and can also be a side effect of certain drugs. Here are some possible causes: Congestive heart failure may result in edema. To compensate for heart failure, in which the heart fails to circulate adequate amounts of blood, the kidneys retain sodium to help the body hold on to water and increase the volume of blood. Deep vein thrombosis, the formation of a blood clot in a deep vein within the leg, can cause edema by damaging the valves within the veins that control normal blood flow. This type of edema most commonly makes the ankles swell but may also cause swelling in the calf or even the thigh. Kidney diseases, such as diabetic nephropathy, may cause edema due to excess sodium and fluid retention. Edema may be a side effect of certain drugs, including the oral diabetes drugs pioglitazone (brand name Actos) and rosiglitazone (Avandia). People sometimes experience mild edema when starting on insulin therapy, but this generally goes away within a few weeks. If you experience any unusual swelling, be sure to contact your doctor. It may be the result of a medical condition you don’t know you have. Treating edema involves treating the underlying medical condition that is causing it or adjusting medication as necessary. This article was written by Robert S. Dinsmoor, a Contributing Editor of Diabetes Self-Management. Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provide Continue reading >>

An Unusual Cause Of Generalized Insulin Edema And Truncal Neuropathy

An Unusual Cause Of Generalized Insulin Edema And Truncal Neuropathy

aDepartment of Diabetes, Royal London Hospital, Barts Health NHS Trust, London, UK bCorresponding Author: Nicola Tufton, Department of Diabetes & Metabolism, John Harrison House, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London E1 1BB, UK Manuscript accepted for publication October 16, 2015 Short title: Generalized Insulin Edema doi: Insulin edema and acute neuropathy are rare side effects of insulin initiation or rapid improvement in glycemic control. Both conditions occurring simultaneously are very rare and there are no previous data on truncal neuropathy as a dominant feature. A 35-year-old lady, who presented with an infected, necrotic fourth finger and was admitted for debridement and antibiotics, developed diabetic ketoacidosis. Past medical history included latent autoimmune disease of adults. She was non-compliant with medication and had experienced significant weight loss (37 kg; body mass index (BMI) 15.1 kg/m2). She was glutamic acid decarboxylase antibody positive, with poor glycemic control (HbA1c 133 mmol/mol (14.3%)). She was treated with intravenous and then subcutaneous insulin. From day 3, she developed significant pitting edema to her umbilicus. She was treated with furosemide 40 mg once daily and fluid restriction. Other causes of edema were excluded. Peak weight gain was 5 kg and edema resolved 2 weeks later. She also developed a painful sensory neuropathy over dermatomes T12-L2 on day 5, which persisted for several months before resolution. Magnetic resonance imaging was normal and nerve conduction studies showed generalized diabetic sensorimotor neuropathy. This is the first report of edema and truncal neuropathy developing secondary to insulin initiation and a rapid improvement in glycemic control. Our case was particularly sus Continue reading >>

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