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Question:

From Sandston, Virginia, USA:

My daughter was diagnosed 10 weeks ago with type 1. Her blood sugar in the hospital was 600 mg/dl [33.3 mmol/L]. Her A1c was 18.0. She is on 15 units of Lantus, seven units of lispro at dinner and 25 units of NPH and seven units of lispro in the morning. She is 5 feet tall and weighed 105 pounds prior to diagnosis. Four weeks later, she had gained 25 pounds and had pitting edema all over. She stared loosing her hair in handfuls. They checked her thyroid and it was normal. We have decreased insulin some (used to take 32 units of NPH and up to 10 units of lispro) and they called it insulin edema.

Her sugars are still high. An average day: 247 mg/dl [13.7 mmol/L],75 mg/dl [4.2 mmol/L],261 mg/dl [14.5 mmol/L], and 250 mg/dl [13.9 mmol/L]. Last night, it was almost 400 mg/dl [22.2 mmol/L]. She has since gained 10 more pounds. I have cut carbohydrates since the second week after diagnosis because they had her on so many. It does not seem to be all "weight." She still seems so full of fluid. They did start her on Aldactone, twice a day. She has not gained any weight for two weeks and is not having the pitting edema as much. However, it is still there. She also is on the birth control pills and has only had spotting for one or two days since being diagnosed. They have never done any antibody studies. Do you think this is a normal for this insulin edema to last this long? They said the hair loss is stress. What about this fluid gain? She is very active. We are seeing a counselor for depression cause it seems no matter what she does this will not go away. I read your web site all of the time now and I even took one of your articles in and that is why one of the doctors agreed to try the diuretic.

Answer:

None of what you describe is normal, but it can occur. The key would be to do specific tests of fluid, salt, protein, blood pressure and kidney function as well as thyroid, adrenal, celiac testing to see if there is another cause. Insulin edema, while rare, usually resolves over time and usually also responds to diuretics. I would go back to your diabetes team and get more information about their thoughts and plans. Depression is also usually not so severe unless there has been depression before. Fluid retention can be a contributing factor with depression as well.

SB

DTQ-20050614131330
Original posting 25 Jun 2005
Posted to Other and Insulin

  
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Last Updated: Tuesday April 06, 2010 15:10:02
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