Edema

I’ve been looking online for the answer to this and can’t find it. I have type1 and for the last month or so I’ve been having tons of swelling in my legs, we’re talking beyond cankles! I noticed it starting after I was in the hospital in February for DKA. I had an issue with this about a year ago but it went away in a few days… not weeks to months of constant swelling. My numbers have been okay, a few lows and a few highs, but nothing really to stress over. Anyone have any ideas or had anything similar? I’m getting tired of only being able to wear flip-flops!

Help!

Elizabeth

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I noticed when I was taking large doses of Humalog that I had some swelling as well, but I was also eating a LOT of beef jerky (only 5 carbs!). Now that I’m off Humalog for the most part, I haven’t had issues with swelling in my feet and calves. I know that edema can indicate cardiac issues so you may want to mention it to your doctor. It’s important to know if you are taking other medications that can cause this. I’ve heard that Humalog can cause “some” edema but I don’t think to the extent you are talking about. I’d also take another look at your diet to see if you are consuming “hidden” sodium. Aside from that, I’d talk to your doc. You may need pressure stockings or medications. Not to mention it could be something more serious, although I couldn’t tell you what. Good luck!

Where did you hear about Humalog and edema? I’ve been using Humalog since 1998 or so when it first came to Canada, and for the past few years I’ve had problems with edema. But then it may also have been a side effect of the ARB I was taking, because I’ve had WAY less of a problem since I stopped taking that.

Edema can also be a sign of kidney problems. I would definitely see your doctor and get some tests and bloodwork done if you haven’t already, to rule out anything serious.

I can’t remember where exactly. I’ve worked in medical offices as a Manager and Receptionist for the last 5 years and I pick up a lot but can’t always place it. Sorry. :frowning:

When in doubt, see I doctor. For a few weeks after I was also confined in a hospital due to Gastritis, I also had swelling of both my feet. Mine however at that time was due to excess sodium and water retention. At that time too, I was so underweight. After a a month of treatment and proper diet, it went away. Though there may be other causes related to but not limited to diabetes. Edema may be a side effect of certain meds, like oral diabetes drugs pioglitazone (Actos) and rosiglitazone (Avandia). And I heard that sometimes some experiences mild edema when starting on insulin therapy, but goes away within a few weeks.

Let us know what your doctor says.

I had general swelling after my DKA experience. My fingers looked like sausages & my face was round & puffy. It slowly went away in a couple of weeks. I think it’s due to do with how imbalanced our electrolytes become during DKA.

Even with edema, it’s important to drink enough water.

Thanks everyone for the input. I’m however not on Humalog nor taking orals. I’ve been super thirsty lately and I have increased my water consumption to around 5 liters a day. I do not take in extra salt/sodium and I’m really careful with “hidden salts.” I don’t have an appointment till next month with my endo but I will call his office and see what he says or wants to do.

Thanks again!

Elizabeth

Hey Elizabeth,
Not sure if you are, but when I have swelling issues, my nephrologist has me weigh myself every day to keep track of how much water I am retaining. He has given me ranges of fluctuation that are safe, and what to do when it goes outside that maximum weight change (either per day or per week)

I also have trouble if my potassium and sodium levels are too low. Of course, I am also light headed. Maybe not the problem, but maybe to consider.

How are your BGs? You only control them through your diet?

No, I’m a type 1 on an insulin pump. I don’t eat too badly, but nothing completely crazy.

Do you pump Novolog?

Has your kidney function been checked?

I’m on an insulin pump and using Apidra. I also have “chronic edema” issues - mostly lower legs and feet - at times very uncomfortable! Been tested for the usual suspects. I talked with my endo about this at my recent appointment. He said that for some people, insulin can be hydrophilic - and cause excess water retention, similar to excess salt. I have noticed that the problem is worse when I need/use more insulin for higher-carb periods or illness.

As he does NOT want me taking a diuretic, his best suggestion was to make sure to more around a lot – break up long periods of sitting or standing with walking around, etc.

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@Thas, you should speak with @Captain

I am curious if people who experience edema from diabetic or other related causes have the same symptoms as those of cardiac problems (redness, sensitivity, slow healing, hair loss). I know I have a bit of protein leakage in my kidneys (apparently not so much that any of my doctors have decided that I need anything more than blood pressure meds), and I get varying levels of edema, but also hair loss and redness/sensitivity. I am going to ask my regular doc tomorrow when I go, but I am curious if it is common to have all the symptoms I do.

Sensitivity, I suppose yes.
What kind of redness? I get clear signs in the affected areas of chronic edema.
I have not seen any signs of hair loss related to the edema, not have I seen any indication of slow healing. I do see a direct connection between the amount in insulin I need/use and the level of edema. My cardiac and kidney functions have tested normal.

Not like super red, but often there is a clear slight red tint for me.

I’ve been dealing with edema for the better part of 2 years, this has been my experience:

  • First, I’m nearly 60, type 1 for 55 years. Been well controlled and on a pump past 3 years (A1C was 5.6 last week).
  • I’d had minor ankle swelling (peripheral edema) which was well controlled with Lasix until 20 months ago, when I was admitted to the hospital for treatment of pneumonia (and a 10 day stay).
  • While in the hospital my edema was significantly worse, and I was diagnosed with congestive heart failure.
  • Since that time, I’ve relied on higher doses of Lasix as well as compression socks. Even so, there was excessive swelling of feet and ankles (especially left ankle)
  • I’ve been on BP meds for 20 years (now taking 4: Irbesartan, Amlodipine, Terazosin & Bisoprolol

Significantly, the above combination of meds was unable to produce a stable near-normal blood pressure, and my edema remained a problem. Until 4 weeks ago …

Earlier this year I was finally diagnosed with the cause of my inability to breathe (yet another issue I have): Pulmonary Hypertension. The only drug they can prescribe to dilate my arteries is nitro (via dermal patches).

And guess what? For the 1st time in over 20 years my blood pressure is 110/50. And there’s no edema. No more compression socks.

If you have edema, you likely have had kidney disfunction for some time, but it’s likely you also have CHF.

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Congrats on discovering a fix for your situation! Maybe others could enjoy some relief with this treatment.

Do you know of any side-effects to dosing nitroglycerin this way? I wonder if the effect, vasodilation, diminishes with continuous long-term use.

Terry - as long as you remove the dermal patch for 10-12 hrs each night the nitro works as advertised. The only troublesome side effects are hypotension (light-headedness / dizziness). Just have to be very careful to the dosage.