Insulin Edema in the Twenty-first Century: Review of the Existing Literature

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.