Insulin edema in a diabetic child.

A 10-year-old boy had poorly-controlled diabetes for one year. He experienced weight gain and pitting edema in both lower legs and the scrotum 5 days after initiation of insulin therapy for diabetic ketoacidosis. The diagnostic work-up for this patient revealed no evidence of cardiovascular, renal, or hepatic disease. Thiazide was prescribed, but the patient did not take it. Because of family problems, he discontinued insulin therapy and the edema subsided within 2 to 4 days. This case illustrates that the possibility of localized or generalized edema should be considered during the introduction of insulin therapy in poorly-controlled diabetes.