Insulin pump and ankle swelling?

[M.Schoon]

Hi,
I am curious if anyone else has had the experience that I am getting from my insulin pump. I find it so strange when I inject I never have my left ankle swelling but within 24 hours of using my pump it starts to swell. I ruled out the temperature, and humidity as that normally will cause swelling. I do not have any other health conditions that would cause it. I have tested it multiple times with the same result. I have spoken to my diabetes doctor and he has never heard of it before. If anyone out there knows of this, please let me know.
Thanks!

 

[oldgreymare]

Hi,
I am curious if anyone else has had the experience that I am getting from my insulin pump. I find it so strange when I inject I never have my left ankle swelling but within 24 hours of using my pump it starts to swell. I ruled out the temperature, and humidity as that normally will cause swelling. I do not have any other health conditions that would cause it. I have tested it multiple times with the same result. I have spoken to my diabetes doctor and he has never heard of it before. If anyone out there knows of this, please let me know.
Thanks!

We're not allowed to diagnose, so you should really contact your GP /hospital team for more help with what may be going on. I've certainly experienced ankle swelling when in hot climates, long time sitting or driving, sunburn, insect bite reactions, etc. When I first went on insulin (MDI) 16 years ago I had been chronically dehydrated, so my lower legs swelled very dramatically, but fortunately my circulation, kidneys, etc then stabilised quite quickly so I haven't attributed any subsequent swelling episodes to insulin.

Did you change insulins when you started pumping? Where do you wear your insulin pump? At least in my experience it seems quite unlikely that a hormone (i.e., insulin) response would affect one leg only. But other conditions could be involved, so I do suggest you follow up with your GP, not just the diabetes team.

 

[M.Schoon]

We're not allowed to diagnose, so you should really contact your GP /hospital team for more help with what may be going on. I've certainly experienced ankle swelling when in hot climates, long time sitting or driving, sunburn, insect bite reactions, etc. When I first went on insulin (MDI) 16 years ago I had been chronically dehydrated, so my lower legs swelled very dramatically, but fortunately my circulation, kidneys, etc then stabilised quite quickly so I haven't attributed any subsequent swelling episodes to insulin.

Did you change insulins when you started pumping? Where do you wear your insulin pump? At least in my experience it seems quite unlikely that a hormone (i.e., insulin) response would affect one leg only. But other conditions could be involved, so I do suggest you follow up with your GP, not just the diabetes team.

Hello Oldgreymare,
Thanks for your response. I understand that no one is allowed to diagnose. I have contacted my GP and I have spoken with my diabetes doctor. They have never seen this before. So, hence trying to see if anyone else has had this kind of experience. Certainly, hot climates, sitting/driving/flying, I will get that as well. But I find it rather ironic it does with the pump as well.
I have not changed my insulin. It is the same as I use in my pens for years. I am assuming you mean where I place my infusion set? If so, it is on my belly. I am finding this so frustrating as the pump is awesome and keeps my sugar levels so balanced like never before.

 

[Hopeful34]

Hello @M.Schoon and welcome to the forum. I'm sorry you're having this problem with your insulin pump. I've not heard of anyone asking about this before, but can imagine how frustrating it is for you.
Did the swelling start within days of you beginning pump therapy? I don't know if it would help, but the only thing I can suggest is trying a different insulin, and keeping well hydrated.

 

[M.Schoon]

Hello @M.Schoon and welcome to the forum. I'm sorry you're having this problem with your insulin pump. I've not heard of anyone asking about this before, but can imagine how frustrating it is for you.
Did the swelling start within days of you beginning pump therapy? I don't know if it would help, but the only thing I can suggest is trying a different insulin, and keeping well hydrated.

Thanks for your response and welcoming me. It starts within the first 24 hours. Here in the Netherlands our temperatures have been above average (of course) and that will cause swelling. However, this also happens in the winter. I have tested so many different times and in different season. I have had the pump since 2021. The first week it did not and then (if I recall correctly) the following week it started. I got my pump in November, so that would not account for temperatures. I have tried several other insulins and novorapid has worked the best for me since 2001. What is also weird if I inject with my pen it does not happen.

 

[Hopeful34]

Just to clarify - forgetting your diabetes control for a moment - do you still get the swelling no matter which insulin you use in your pump? Have you tried all the available insulins including fiasp?

If you've done all this, the only other thing I can think of is to suggest only using the pump for your basal insulin and inject for meals, thereby seeing what happens if you have less insulin going through the pump. No idea if that will make any difference at all, (and not a long term solution) but anything's worth a go.

When on pens you'll have less rapid acting insulin circulating in your body, so is the problem related to volume??

 

[M.Schoon]

I have tried several types but only novorapid works best for me. .. I also tried that but it does not keep my levels stable and sadly still swelling. (My diabetes nurse said not to turn the basal off but I did it anyway.. lol.)
That was one of my thoughts as well. I have changed my basal rate lower. I am hoping that will help. Fingers crossed. It is just so weird...

 

[oldgreymare]

I have tried several types but only novorapid works best for me. .. I also tried that but it does not keep my levels stable and sadly still swelling. (My diabetes nurse said not to turn the basal off but I did it anyway.. lol.)
That was one of my thoughts as well. I have changed my basal rate lower. I am hoping that will help. Fingers crossed. It is just so weird...

Actually, maybe its not so weird. If by using a pump with Novorapid you have been able to significantly improve your blood glucose control, but now experiencing side effects of more water retention, ankle swelling, etc - this may indicate that you could have been chronically dehydrated to some degree on the poorer control of an injection regime. Your body may now be reflecting your true normal hydration state. Turning off basal completely sounds a really bad idea, but obviously experiment with the lowest levels that keep your fasting BGs consistent.

But fixing the water retention, ankle swelling perhaps now needs focusing on other factors as well as optimising your BG control - for me using a very low carb diet works better than low salt approach to reduce swollen ankles, but personally lots of daily walking exercise has been the absolute best help to mean I go to bed with "scrawny" ankles & feet. However I remember you originally mentioned only one foot swelled - IMHO this sounds like a result of a leg specific injury - please follow up, up as doesn't seem relevant to changing insulin regimes.

 

[M.Schoon]

Thanks for your response . On injections my levels were still pretty good. We decided to do the pump because of all the needle stabbing. (Also, I find it annoying to inject at a dinner table when you are eating in a restaurant.) However, it did bring down my A1C more. I am not sure if I would say I have been dehydrated as I drink a lot of water throughout the day. Coffee only 1 time a day and tea in the afternoon. For the rest it is water. My urine color is showing no signs of dehydration. turning off the basal rate was an adventure! I wanted to see if that made a difference. I added levemir at night to compensate. However, it seems the lower basal rate is helping a bit. I have been in low carb since diagnosed in my 20's. I walk my dogs daily and if the weather is not great then I go on the treadmill. Last week I was sent to have my leg x-rayed. There was no injury, no osteoarthritis (like in my lower back and upper spine). OH my! Maybe just an odd thought..... Starting to go into menopause. Perhaps, that is a possible reason? The body is doing wonky things????