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  • Title: Does the use of insulin in a patient with liver dysfunction increase water retention in the body, i.e. cause insulin oedema?
    Author: Zenda T, Murase Y, Yoshida I, Muramoto H, Okada T, Yagi K.
    Journal: Eur J Gastroenterol Hepatol; 2003 May; 15(5):545-9. PubMed ID: 12702914.
    Abstract:
    A 68-year-old female with mild diabetes mellitus was admitted because of acute liver dysfunction due to autoimmune hepatitis. While 40 mg/day of prednisolone improved hepatic dysfunction dramatically, her diabetic milieu deteriorated seriously. The induced hyperglycaemia could not be controlled sufficiently, despite a high dose of insulin (> 110 units/day), suggesting the existence of insulin insensitivity and hyperinsulinaemia. Soon after introduction of insulin therapy, she developed severe anasarca, including marked peripheral oedema, ascites and pleural effusion. Anasarca eventually subsided within 4 weeks with the use of a diuretic agent. We conjectured that the side effects of insulin, such as anti-natriuresis and increased vascular permeability, might be pronounced in the presence of the hepatic dysfunction that accompanies insulin insensitivity, hyperinsulinaemia and hypoalbuminaemia.
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