BMJ  2006;333:1257-1260 (16 December), doi:10.1136/bmj.39043.398738.DE

Practice

Cases in primary care laboratory medicine

Hypertriglyceridaemia in diabetes

W Stuart A Smellie, consultant

1 Clinical Laboratory, General Hospital, Bishop Auckland DL14 6AD

info@smellie.com

Mild hypertriglyceridaemia is common in diabetes, but patients with newly presenting or poorly controlled diabetes may have a quantitatively different syndrome of gross hypertriglyceridaemia, which should be treated by optimising glycaemic control before use of lipid lowering drugs

The first 150 words of the full text of this article appear below.

Introduction


Summary points

  • Diabetes can be associated with massive hypertriglyceridaemia, with serum triglyceride concentrations ≥100 mmol/l in extreme cases
  • Severe hypertriglyceridaemia represents an extreme of the classic blood lipid pattern in diabetes. It carries a risk of acute pancreatitis, and will be missed if serum triglycerides are not measured. Lipaemic samples should always prompt measurement of fasting triglyceride by the laboratory
  • Diabetes and impaired glucose tolerance are common findings in patients with hypertriglyceridaemia. Fasting glucose should be measured, and a glucose tolerance test performed if indicated, in hypertriglyceridaemic patients
  • Hypertriglyceridaemia due to poor diabetic control does not respond well to lipid lowering agents. Treating the diabetes is the first priority, although many patients will also have an underlying dyslipidaemia
  • Serious metabolic consequences of poor diabetic control are not reflected in patients' symptoms


Diagnostics lack the robust evidence base available to other interventional medical practices, but considerable consensus guidance obtained from observational and intervention . . . [Full text of this article]

Case 1

Case 2

Discussion

Questions and answers: learning points


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This article has been cited by other articles:

  • Cole, R. P. (2009). Heparin Treatment for Severe Hypertriglyceridemia in Diabetic Ketoacidosis. Arch Intern Med 169: 1439-1441 [Abstract] [Full text]  
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