Insulin-induced edema: an unusual complication in a patient with diabetic ketosis

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Published Nov 15, 2017
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Vol. 95 No. 2 (2017): Issue Feb 2017

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Fatma Chaker
Meriem Yazid
Mélika Chihaoui
Amel Rached
Hédia Slimane

Abstract

The insulin-induced edema is a rare complication of insulin therapy. Two mechanisms are known, the sodium and water retention and vasoactive
mediator’s release. We report the case of a 32 years-old patient, with a history of diabetes for one month treated with metformin. He was
hospitalized for diabetic ketosis and developed lower legs edema and scrotum edema, few hours after the insulin injections. Biologic tests
showed hypoprotidemia without proteinuria and hyponatremia. The abdominal ultrasound showed a liver steatosis. Chest radiography was
normal. Transthoracic echocardiography showed a moderate pericardial effusion. Edema resolved spontaneously one month later. Protidemia
and natremia were normalized. The natural history of insulin-induced oedema was observed in our patient and the accountability of insulin is
likely, but invetstigations are often needed to eliminate other causes of edemas.

Keywords:

Diabetes, ketosis, insulin therapy, edema

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