Severe hypertriglyceridemia in diabetic ketosis

Area of Science:

• Endocrinology
• Metabolic Disorders
• Genetics

Background:

• Diabetic ketosis can present with severe hypertriglyceridemia.
• The underlying cause of severe hypertriglyceridemia in diabetic ketosis is not fully understood.
• Genetic hyperlipidemia is a potential contributing factor.

Purpose of the Study:

• To investigate the prevalence of underlying genetic hyperlipidemia in patients experiencing diabetic ketosis with very severe hypertriglyceridemia.
• To differentiate between genetic and other causes of hypertriglyceridemia in this patient cohort.

Main Methods:

• Prospective study of 211 episodes of ketoacidosis and ketosis.
• Measurement of plasma lipids in 15 patients with initial triglyceride concentrations > 11.3 mmol/L.
• Assessment of diabetes mellitus type (IDDM/NIDDM) and acidemic status.

Main Results:

• Eleven of 15 patients had insulin-dependent diabetes mellitus (IDDM).
• Eight of 15 patients were not acidemic despite ketosis.
• 80% of affected patients were male.
• Plasma triglyceride levels normalized in most patients within a year.

Conclusions:

• The majority of patients with diabetic ketosis and severe hypertriglyceridemia likely do not have an underlying genetic hyperlipidemia.
• Findings contrast with studies on non-insulin-dependent diabetes mellitus (NIDDM) where genetic factors are more common.
• Other factors likely contribute to severe hypertriglyceridemia in IDDM patients with ketosis.