Effective treatment of insulin-induced edema using ephedrine

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.