Hopkins D F, Cotton S J, Williams G
Department of Medicine, University of Liverpool, United Kingdom.
Diabetes Care. 1993 Jul;16(7):1026-8. doi: 10.2337/diacare.16.7.1026.
To control insulin-induced edema in a patient with poorly controlled IDDM.
A 31-yr-old woman with a 14-yr history of poorly controlled IDDM first developed peripheral edema 3 yr after diagnosis of IDDM; the edema worsened whenever insulin dosage was increased. In August 1991, severe edema developed after treatment of ketoacidosis, with body weight increasing from 46 to 61 kg. No evidence of cardiac dysfunction or autonomic neuropathy existed, and serum albumin was consistently normal.
Treatment with 15 mg of ephedrine every 8 h produced a prompt diuresis, with body weight falling by 4 kg in 48 h and by 12 kg within 1 wk.
Ephedrine may be an effective treatment for insulin-induced edema and may be preferable to the use of diuretics in such patients.
控制一名胰岛素依赖型糖尿病（IDDM）控制不佳患者的胰岛素诱导性水肿。
一名31岁女性，有14年IDDM控制不佳病史，在IDDM诊断3年后首次出现外周水肿；每当胰岛素剂量增加时，水肿就会加重。1991年8月，在酮症酸中毒治疗后出现严重水肿，体重从46公斤增加到61公斤。没有心脏功能障碍或自主神经病变的证据，血清白蛋白一直正常。
每8小时服用15毫克麻黄碱治疗可迅速产生利尿作用，体重在48小时内下降4公斤，1周内下降12公斤。
麻黄碱可能是治疗胰岛素诱导性水肿的有效药物，在此类患者中可能比使用利尿剂更可取。
