Recurrent insulin edema in an adolescent with type 2 diabetes mellitus

Insulin edema is a rare complication of insulin therapy in both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), typically following the initiation or intensification of treatment. It has been associated with both long-acting and short-acting insulin formulations and is most observed in newly diagnosed patients. We report on the case of a 13-year-old patient with recurrent insulin edema, first occurring after the initiation of insulin therapy and again following the transition to a closed-loop insulin pump system. The diagnosis of insulin edema was made after excluding cardiac, renal, and hepatic dysfunction. The first episode required a 3-day course of diuretic therapy, along with fluid restriction and a low-sodium diet. The second episode occurred following the initiation of insulin pump therapy and resolved within 3 days after a single dose of diuretic treatment combined with a low-sodium diet and fluid restriction.