Title:Non-glycemic Adverse Effects of Insulin
Volume: 18
Issue: 2
Author(s): Alissa M. Guarneri and Robert P. Hoffman*
Affiliation:
- Department of Pediatrics Division of Endocrinology Nationwide Children's Hospital The Ohio State University College of Medicine Columbus, OH 43205, USA
Keywords:
Insulin, adverse effects, edema, allergy, lipohypertrophy, lipoatrophy.
Abstract: Insulin is primarily considered for its glycemic effects in patients with diabetes. There
are, however, non-glycemic adverse effects of insulin that may significantly impact patient health
and interfere with glycemic control. Insulinogenic edema primarily occurs with rapid improvement
in glycemic control either in patients with newly discovered diabetes or in patients with poorly-controlled
diabetes. Insulin-induced sympathetic activation, vasodilation, changes in vascular permeability,
and most importantly, sodium retention play significant etiologic roles in the development of
edema. Clinically, it is usually self-limited, but significant complications can develop. Allergic reactions
to all insulin preparations and various compounds used in insulin formulations with a wide
range of severity have been reported. Frequently, changing the type of insulin or delivery method
is sufficient, but more advanced treatments such as insulin desensitization and anti-IgE antibody
treatment may be needed. Lipohypertrophy and lipoatrophy frequently develop with the overuse of
injection sites. Lipohypertrophy can affect tissue insulin absorption and glycemic control.
