{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:09:48Z","timestamp":1783487388986,"version":"3.55.0"},"reference-count":10,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Insulin edema is a poorly understood complication of insulin therapy. It has been reported in patients with both type 1 and 2 diabetes mellitus and typically occurs in patients with newly diagnosed or poorly controlled diabetes mellitus either after initiation or intensification of insulin therapy. A 20-year-old man presented with anorexia, polydipsia, and weight loss. Serum glucose on admission was 824\u2005mg\/dL (45.8\u2005mmol\/L) and hemoglobin A1c was &amp;gt;14.0. Additional workup was notable for positive anti-IA2 antibodies and low C-peptide of 0.5\u2005ng\/mL (1.1-4.4\u2005ng\/mL). He was diagnosed with type 1 diabetes mellitus and was started on insulin therapy with glargine and lispro. Within 4 days after insulin initiation, he developed bilateral leg swelling and reported a 25-pound (11.3-kg) weight gain over the next 10 days. After excluding other systemic causes of edema such as heart failure, renal failure, and liver failure, a diagnosis of insulin edema was made. Insulin glargine was switched to insulin degludec. Complete resolution of edema occurred within 3 days of switching the insulins. Insulin edema is a diagnosis of exclusion. Insulin's role in renal sodium handling, vasodilation, and increased vascular permeability have been postulated as possible mechanisms. Clinicians should be aware of this rare complication.<\/jats:p>","DOI":"10.1210\/jcemcr\/luad158","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T18:14:18Z","timestamp":1703009658000},"source":"Crossref","is-referenced-by-count":4,"title":["Insulin Edema Associated With Glargine"],"prefix":"10.1210","volume":"2","author":[{"given":"Jessica","family":"Wood","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University Health , Richmond, VA 23298 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Samji","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University Health , Richmond, VA 23298 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-7052","authenticated-orcid":false,"given":"Francesco S","family":"Celi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut , UConn Health 263 Farmington Avenue , Farmington, CT 06030-8075 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-4726","authenticated-orcid":false,"given":"Priyanka","family":"Majety","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University Health , Richmond, VA 23298 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"issue":"1","key":"2024010813092109100_luad158-B1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/0002-9343(85)90562-5","article-title":"Insulin-induced cardiac failure","volume":"79","author":"Sheehan","year":"1985","journal-title":"Am J Med"},{"issue":"4","key":"2024010813092109100_luad158-B2","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0272-6386(04)00960-6","article-title":"The edematogenic properties of insulin","volume":"44","author":"Kalambokis","year":"2004","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"2024010813092109100_luad158-B3","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s00592-014-0707-7","article-title":"Bilateral lower limbs edema with \u201cwooden\u201d character induced by insulin glargine treatment","volume":"52","author":"Succurro","year":"2015","journal-title":"Acta Diabetol"},{"issue":"3","key":"2024010813092109100_luad158-B4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1007\/BF00279940","article-title":"Poor metabolic control, hypertension and microangiopathy independently increase the transcapillary escape rate of albumin in diabetes","volume":"25","author":"O\u2019Hare","year":"1983","journal-title":"Diabetologia"},{"key":"2024010813092109100_luad158-B5","volume-title":"Package Insert","author":"Lantus","year":"2022"},{"key":"2024010813092109100_luad158-B6","volume-title":"Package insert","author":"Tresiba","year":"2015"},{"key":"2024010813092109100_luad158-B7","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2012-007037","article-title":"Generalised insulin oedema after intensification of treatment with insulin analogues","volume":"2013","author":"Adamo","year":"2013","journal-title":"BMJ Case Rep"},{"key":"2024010813092109100_luad158-B8","doi-asserted-by":"crossref","first-page":"e931960","DOI":"10.12659\/AJCR.931960","article-title":"Insulin-induced edema in a patient with type 2 diabetes mellitus","volume":"22","author":"Elmahal","year":"2021","journal-title":"Am J Case Rep"},{"issue":"3","key":"2024010813092109100_luad158-B9","first-page":"e7234","article-title":"Anasarca in newly diagnosed type 1 diabetes: review of the pathophysiology of insulin edema","volume":"12","author":"Wong","year":"2020","journal-title":"Cureus"},{"issue":"2","key":"2024010813092109100_luad158-B10","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin Pharmacol Ther"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/2\/1\/luad158\/55115077\/luad158.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/2\/1\/luad158\/55115077\/luad158.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T13:42:01Z","timestamp":1704721321000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luad158\/7478577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,12,15]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luad158","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1]]},"published":{"date-parts":[[2023,12,15]]},"article-number":"luad158"}}