Bilateral pleural effusions, ascites, and facial and peripheral oedema in a 19-year-old woman 2 weeks following commencement of insulin lispro and detemir--an unusual presentation of insulin oedema.
Insulin oedema is a rare complication of insulin therapy and usually occurs in patients with Type 1 diabetes. It can present in a variety of ways, from mild peripheral oedema to cardiac failure and massive serosal effusions. We report a 19-year-old woman with newly diagnosed Type 1 diabetes who presented with bilateral pleural effusions, ascites and extensive peripheral oedema 2 weeks after starting insulin therapy. Significant cardiac disease was excluded, and the massive fluid retention resolved spontaneously with conservative management. A review of the literature is presented.
Lee
P
P
Department of Endocrinology and Metabolism, Concord Repatriation General Hospital, New South Wales, Australia. pcylee@gmail.com
Kinsella
J
J
Borkman
M
M
Carter
J
J
D000328:Adult; D001201:Ascites / Q000209:etiology / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis; D004487:Edema / Q000209:etiology / Q000235:genetics / Q000628:therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000378:metabolism; D007328:Insulin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000378:metabolism; D061268:Insulin Lispro; D010996:Pleural Effusion / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D015431:Weight Loss
D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro