Md Aris Mohd Aznan, Tan Kui Foung, Said Abdul Hadi
MD (USM), MMed (Family Medicine) (USM), Department of Family Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
MD (UKM), Department of Family Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia, Email:
Malays Fam Physician. 2022 Mar 10;17(1):94-98. doi: 10.51866/cr.6. eCollection 2022 Mar 28.
Insulin oedema is a rare condition that may occur after the initiation or rapid intensification of insulin therapy in patients with long-standing hyperglycaemia, commonly with type 1 diabetes mellitus (DM). We reported a case of insulin oedema in a patient with type 2 DM who presented with swelling of the extremities and weight gain of 3 kg 1 week after insulin initiation. A course of furosemide was administered, but no significant immediate improvement was observed; however, the lower limb swelling resolved spontaneously after 3 months of follow-up. The patient also achieved adequate diabetic control with insulin, as shown by the reduction of her HbA1c from 10.7% to 6.9% over 6 months. Insulin oedema is a diagnosis of exclusion after ruling out other differential diagnoses, such as cardiac, renal, or liver failure. Although insulin oedema carries with it a good prognosis, physicians should be aware of the condition to avoid misdiagnosis.
胰岛素性水肿是一种罕见的病症，可能发生在长期高血糖患者（通常为1型糖尿病）开始胰岛素治疗或快速强化胰岛素治疗之后。我们报告了1例2型糖尿病患者发生胰岛素性水肿的病例，该患者在开始使用胰岛素1周后出现四肢肿胀和体重增加3千克。给予了一个疗程的呋塞米治疗，但未观察到明显的即时改善；然而，随访3个月后下肢肿胀自行消退。患者使用胰岛素后血糖也得到了良好控制，6个月内糖化血红蛋白从10.7%降至6.9%。胰岛素性水肿是在排除其他鉴别诊断（如心脏、肾脏或肝脏衰竭）后做出的排除性诊断。尽管胰岛素性水肿预后良好，但医生应了解这种情况以避免误诊。
