Puffy face since starting insulin

[Veronica Wright]

Hi everyone,

Since starting insulin injections last week, my face is getting puffier each day, especially my eyes which look awful. I saw my doctor today and he said he couldn't prescribe any diuretics yet until we get a grip on the blood sugar and could bother my kidneys. I have to deal with the public and I feel so humiliated and depressed to look like this. I eat low sodium, low carbs, watch the sugar (big time) and I drink a lot of water. Has this happened to anyone else -- and what can you do about it?

 

[kitedoc]

Hi @Veronica Wright,
Writing as a Type 1 diabetic, not as medical advice or opinion:
It says on your info that you are Type 2 now on insulin.
What medications were you on for diabetes in the past.?
Asking this to make sure whether it is stopping other medications that may be the cause or adding
to your current troubles.
Insulin does affect the level of salt in the body so maybe that is the related to your swelling?
What is your weight doing? If it is increasing that may suggest extra fluid building up in your body
as opposed to just your face.
What insulin are you prescribed?

 

[Veronica Wright]

Hi @Veronica Wright,
Writing as a Type 1 diabetic, not as medical advice or opinion:
It says on your info that you are Type 2 now on insulin.
What medications were you on for diabetes in the past.?
Asking this to make sure whether it is stopping other medications that may be the cause or adding
to your current troubles.
Insulin does affect the level of salt in the body so maybe that is the related to your swelling?
What is your weight doing? If it is increasing that may suggest extra fluid building up in your body
as opposed to just your face.
What insulin are you prescribed?

Hi Kitedoc, thank you for answering! That's correct - type 2 and just started on Basaglar insulin a week ago. I was diagnosed about 15 years ago as a side effect of Cushing's Syndrome and managed well with metformin until February. I became really ill suddenly for weeks -- exhausted, ravenous thirst, started losing weight like crazy, and worse -- really blurry vision (which still hasn't righted itself . Nothing changed in my diet, habits or medications, so I was shocked that my blood glucose had spiked to 4x normal.

I'm hearing that this isn't a normal side-effect of insulin -- I really need to figure this out. So awful.

 

[NewlyLADA]

Have you been tested for LADA or type 1.5 ? Just curious as I had symptoms similar to yours when diagnosed. How’s your ketones?

 

[DCUKMod]

@Veronica Wright - That all sounds quite distressing for you. Are your team doing any additional tests to ascertain what your levels of naturally produced insulin is and so on?

Just on the swelling; counterintuitively, I find if I become dehydrated, I develop swollen ankles, my hands and feet swell, making them stiff and so on. If the newly introduced insulin is helping with the raging thirst, are you drinking enough?

 

[kitedoc]

Hi Kitedoc, thank you for answering! That's correct - type 2 and just started on Basaglar insulin a week ago. I was diagnosed about 15 years ago as a side effect of Cushing's Syndrome and managed well with metformin until February. I became really ill suddenly for weeks -- exhausted, ravenous thirst, started losing weight like crazy, and worse -- really blurry vision (which still hasn't righted itself . Nothing changed in my diet, habits or medications, so I was shocked that my blood glucose had spiked to 4x normal.

I'm hearing that this isn't a normal side-effect of insulin -- I really need to figure this out. So awful.

Hi @Veronica Wright, Thank you. On webmed.com - basaglar - common and rare side-effects it mentions swelling of arms, legs, hands and feet and on drugs.com - it mentions swelling also of the face as a side-effect.
On a different note please look at diabettech.com Lantus-lethal-or-saviour to understand an unrelated-to-face swelling issue with this insulin (Lantus = basaglar). Best Wishes with whatever you and your doctor decide to do.

 

[Veronica Wright]

Have you been tested for LADA or type 1.5 ? Just curious as I had symptoms similar to yours when diagnosed. How’s your ketones?

Hi there, thank you so much for your great notes - I didn't know Basaglar was called Lantus. The swelling has gone down a bit since I've been taking vitamin b6 and potassium, and hoping it will go away completely soon. I did slow down on the water as I had been drinking around 19 litres a day, now I'm averaging a more normal 7-10 litres could be a lashback from that as well?

 

[kitedoc]

I would be seeing your doctor, mention your past and present water intake as soon as possible !!

 

[DCUKMod]

Blimey, @Veronica Wright , my question about dehydration was way off beam there! I do however agree with @kitedoc that mentioning your fluid intake to your Doc could be important.

Over hydration can get tricky too.

 

[Veronica Wright]

Thank you so much, much appreciated, everyone!

I'm restraining my water intake, the doctor was worried I was taxing my kidneys too much with 18 litres +; and to try to stay at the 7-11 litres a day. It's funny/ironic? now that I have to limit water I'm just as obsessed with drinking it, but managing to log and track, and sip, not guzzle.

So I guess also this horrid face bloating thing could be a lashback from less water? The b6 and potassium supplements are helping a little.

As the doctor is not happy where I am (down from 16 mmo/l to 14- and thereabouts, fasting blood sugar) so he is adding Januvia (where do they come up with these names? that sounds like an anti-depressant LOL). I took one yesterday and no reaction so I'm glad of that anyways.

Thank you so much, again - it's so nice to talk to others and get advice/feedback. I'm downplaying this to not scare my family and friends and they don't know anything about diabetes anyways.

 

[jjraak]

@Veronica Wright

Sorry to hear your not too good.

Maybe it's a US measure translation issue ..
But I'm pretty sure here the advise is around 3 litres per day...which I barely manage

God knows how you managed to take in your previous totals let alone the current 11 litres...

I'd Google excess water intake.
Not meaning to worry you ...but
The symptoms of swelling cropped up there due to excess water infiltrating the cells.

Sounds like a real issue if you continue without sound medical advice

Best wishes.

 

[Veronica Wright]

@Veronica Wright

Sorry to hear your not too good.

Maybe it's a US measure translation issue ..
But I'm pretty sure here the advise is around 3 litres per day...which I barely manage

God knows how you managed to take in your previous totals let alone the current 11 litres...

I'd Google excess water intake.
Not meaning to worry you ...but
The symptoms of swelling cropped up there due to excess water infiltrating the cells.

Sounds like a real issue if you continue without sound medical advice

Best wishes.

Thanks so much for your thoughtful reply! My doctor is aware and I've cut down on fluids - then the swelling began once I did. I always have lots of water with me in the car, at my desk, at home -- was guzzling down 1/2 liters at a time in one go, all day long. Now I'm sipping and rationing to stay at the 7-11 liters a day.

Thinking the face swelling may be partly due to cutting down on water after the excesses of several months. Body needs to adjust to less water?

 

[tim2000s]

7-11 litres of water a day is still a huge amount of liquid @Veronica Wright. It's possible that prior to going on insulin, your glucose levels were so high that you were drinking a lot and flushing it straight through. Insulin may be adjusting that balance, and you may simply not need as much water as you used to.

I do think you ought to be talking to your Diabetes team about c-peptide tests though, as your symptoms suggest LADA or adult onset type 1 rather than type 2 diabetes.

 

[Veronica Wright]

Thank you so much, this is really interesting advice. I've never heard of c-peptide but will definitely bring it up ASAP. I suppose I could have diabetes type 1 (or maybe as others suggested, 1.5?) This could make a difference in my treatment and I want my doctor to consider more possibilities. I wasn't diagnosed until 15 years ago, and had managed fine on metformin until this recent crisis.

 

[CliveT2]

Hi, I'm in my early 50's and thought I was managing type 2, quite well actually, until the metformin started not working (could tell early thanks to my Libre). I was tested for various insulin antibodies, C-Peptide etc and turns out I'm slow onset type 1 (LADA, Type 1.5, call it what you want, it's type 1 really)....just thought I'd mention as it's definitely worth getting tested. My life has transformed for the better actually and whilst daily jabs and hypo alerts a naus, actually easier to keep your levels in range varying your doses with carbs than type 2.....hey, you can treat yourself to a bit of chocolate (occasionally!),,,

Regarding swelling, I think it's listed as a side effect and likely to occur when you first start taking insulin. I certainly had some swelling in my ankles at first, but has now settled down and now gone away after a couple of months. Hopefully you'll find the same...best wishes

 

[emmay]

Hi, I started on Fiasp about 18 months ago and my legs started swelling up, it took me a while to work it out but it was the change in insulin, my doctor gave me some water tablets which I take on and off but I think my body has got used to insulin so swelling has not been so bad lately.

Hope things sort themselves out for you xx

 

[Veronica Wright]

Hi, I'm in my early 50's and thought I was managing type 2, quite well actually, until the metformin started not working (could tell early thanks to my Libre). I was tested for various insulin antibodies, C-Peptide etc and turns out I'm slow onset type 1 (LADA, Type 1.5, call it what you want, it's type 1 really)....just thought I'd mention as it's definitely worth getting tested. My life has transformed for the better actually and whilst daily jabs and hypo alerts a naus, actually easier to keep your levels in range varying your doses with carbs than type 2.....hey, you can treat yourself to a bit of chocolate (occasionally!),,,

Regarding swelling, I think it's listed as a side effect and likely to occur when you first start taking insulin. I certainly had some swelling in my ankles at first, but has now settled down and now gone away after a couple of months. Hopefully you'll find the same...best wishes

thank you so much for your kind reply, Clive! Same story with me, but not tested yet to see about a correlation to type1 yet. I'm glad that you are doing well and swelling stopped. All the swelling seems to be in my face but it's going down a little with vit b6 and potassium. Hope I can get some diuretics or on something that won't do this. Not to be ungrateful for my medical care but this is kind of awful ;(

 

[Veronica Wright]

Hi, I started on Fiasp about 18 months ago and my legs started swelling up, it took me a while to work it out but it was the change in insulin, my doctor gave me some water tablets which I take on and off but I think my body has got used to insulin so swelling has not been so bad lately.

Hope things sort themselves out for you xx

thank you so much, Emma, that must have been difficult. I doubt any swelling is pleasant! glad to hear the swelling is doing better now for you, and hope it could abate totally soon.

Knock on wood, must my face right now, nothing elsewhere. I hope this will soon go away getting used to it. I'm taking vit b6 and potassium which has helped a bit but not to where I look normal...