Insulin Edema With Use of U-500 Regular Insulin in a Hybrid Closed-Loop Insulin Pump

Vasigh, Mostafa; Mohammady, Janan; Hopkins, Rachel

doi:10.7759/cureus.10886

Cited by 2 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This bears some resemblance to a case described in 2015 in which the patient had obesity, was not insulin naïve, and developed insulin edema a few days after commencing insulin pump therapy, which resulted in a dramatic and abrupt improvement of glycemic control [7]. We also recently reported insulin edema in an adult with type 2 diabetes using automated basal insulin delivery of U-500 insulin (total daily insulin delivery of > 500 units daily; A1c 8.3%) [8]. In contrast, the patient in this report has type 1 diabetes, had significantly lower insulin requirements and achieved better glycemic control.…”

Section: Discussionsupporting

confidence: 72%

Insulin edema after initiation of hybrid closed-loop insulin pump therapy with continuous glucose monitoring: a case report

Vasigh

Hopkins

2022

Clin Diabetes Endocrinol

Self Cite

View full text Add to dashboard Cite

Background Insulin edema is a rare complication which can present after initiation or intensification of insulin therapy in people with diabetes. Initiation of closed-loop hybrid insulin pump therapy can result in rapid improvement in glycemic control for people with diabetes. We present a case in which transition to a closed-loop hybrid insulin pump system, followed by significant improvement in glycemic control, led to development of insulin edema in a person with type 1 diabetes. Case presentation We present a 51-year-old woman with type 1 diabetes of 16 years duration, on insulin pump therapy for more than 10 years, who presented for follow-up 7 weeks after transitioning to a hybrid closed-loop insulin pump system with continuous glucose monitoring (CGM). She complained of weight gain and bilateral lower extremity edema which had started two weeks after the change in pump modality. Laboratory studies and echocardiogram did not reveal any etiology of the acute edema. HbA1c was 3.3% lower than the previous measurement 15 weeks earlier, and there was a significant increase in the daily total insulin dose. With exclusion of other causes of acute edema, the patient was diagnosed with insulin edema and started on hydrochlorothiazide. On follow up, her lower extremity edema significantly improved although her weight did not return to baseline. Conclusion To our knowledge, this is the first case of insulin edema reported in a person with type 1 diabetes using CGM and a hybrid closed-loop insulin pump system. The increase in total daily insulin dose, rapid improvement of glycemic control, and lack of hypoglycemic episodes were important factors to consider in evaluation of this case. Use of hybrid closed-loop systems can help achieve rapid improvement in glycemic control in people with diabetes. This case suggests that consideration should be given to adjusting initial blood glucose targets when starting these remarkable new technologies in people with baseline poor glycemic control.

show abstract

Section: Discussionsupporting

confidence: 72%

Insulin edema after initiation of hybrid closed-loop insulin pump therapy with continuous glucose monitoring: a case report

Vasigh

Hopkins

2022

Clin Diabetes Endocrinol

Self Cite

View full text Add to dashboard Cite

show abstract

“…The types of insulin or insulin treatment have no influence in the occurrence of edema [3,7]. IIE was reported in children receiving NPH and analogue insulins in any insulin type of treatment, including insulin pumps [7].…”

Section: Discussionmentioning

confidence: 98%

Peripheral Insulin Edema and Pericardial Effusion in a 12-Year-Old Newly Diagnosed Girl with Type 1 Diabetes

Janchevska

Jovanovska

Jordanova

et al. 2023

Prilozi

View full text Add to dashboard Cite

Introduction: Insulin induced edema (IIE) is a rare condition, usually found in newly diagnosed diabetes patients, either after insulin treatment initiation or after dose increment. It is a self-limited process, rarely associated with serosal effusions. Teenage girls with type 1 diabetes (T1DM) are most commonly affected. Patient and Methods: A 12-year-old girl was diagnosed with ketoacidosis (DKA). Seven days after initiation of the insulin treatment, at a stable total daily dose of insulin (TDDI) of 0.55 IU/kg, she came with two kilograms weight gain in only two days and edema of the feet and calves. Ultrasound of the heart found a 7 mm pericardial effusion. The diagnostic workout included clinical examination, biochemical, hormonal, allergen analyses and imaging which excluded other known causes of swelling. Conclusions: We describe an adolescent girl with newly diagnosed T1DM and a rare association of peripheral insulin-induced edema and pericardial effusion. Short-term diuretic treatment and salt restriction resolved this rare complication of insulin treatment.

show abstract

Insulin Edema With Use of U-500 Regular Insulin in a Hybrid Closed-Loop Insulin Pump

Cited by 2 publications

References 14 publications

Insulin edema after initiation of hybrid closed-loop insulin pump therapy with continuous glucose monitoring: a case report

Insulin edema after initiation of hybrid closed-loop insulin pump therapy with continuous glucose monitoring: a case report

Peripheral Insulin Edema and Pericardial Effusion in a 12-Year-Old Newly Diagnosed Girl with Type 1 Diabetes

Contact Info

Product

Resources

About