Plasma triglycerides and cholesterol in diabetic ketosis

To better characterize the severity and course of hyperlipidemia in diabetic ketosis and ketoacidosis, we measured plasma triglyceride and cholesterol concentrations in 50 episodes in 46 adults hospitalized on a municipal hospital medical service. Moderate hypertriglyceridemia was common: 32 patients (64%) had triglyceride levels above the 95th percentile (adjusted for age and sex), and 18 patients (36%) had cholesterol levels above the 95th percentile. Severe hypertriglyceridemia (levels above 5.65 mmol/L) was found in 14 patients (28%). Plasma high-density lipoprotein (HDL) cholesterol and the HDL2 and HDL3 subclasses were measured in 22 episodes. The initial HDL cholesterol levels were usually subnormal in the patients who had not received insulin previously and normal in those who had. Treatment of the ketoacidosis was usually associated with a rapid decrease in plasma lipid levels. At late follow-up (between 1 1/2 and 14 1/2 months), only 2 of the 14 patients with initial plasma triglyceride levels above 5.65 mmol/L still had such high concentrations.