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 …