INS and diabetes mellitus: He was started on spironolactone 50 mg/daily and showed a desirable improvement of edema on follow-up.  This case shows that although the use of the hybrid insulin-pump system helps to obtain better control of diabetes in many patients, the rapid improvement in glycemic control may precipitate the development of insulin edema. Furthermore, the use of high concentration insulin in insulin pumps is off-label and their use might increase the rate of complications of insulin therapy including insulin edema.