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Hypertriglyceridaemia and diabetes mellitus: cause or effect?

D J Thomas1, J Stocks, D J Galton

  • 1Department of Diabetes, St Bartholomew's Hospital, London, UK.

Diabetic Medicine : a Journal of the British Diabetic Association
|January 1, 1988
PubMed
Summary

This study highlights two cases where severe hypertriglyceridemia preceded diabetes diagnosis. Effective diabetes management significantly improved triglyceride levels, underscoring the link between these conditions.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Lipid Metabolism

Background:

  • Hypertriglyceridemia, a condition of high triglyceride levels, can precede the diagnosis of diabetes mellitus.
  • Understanding the interplay between hypertriglyceridemia and diabetes is crucial for effective patient management.
  • Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic abnormalities, including dyslipidemia.

Observation:

  • Case 1: A 54-year-old male with hypertriglyceridemia and normal glucose tolerance developed severe hypertriglyceridemia (22 mmol/l) four years later, coinciding with a diabetes diagnosis.
  • Case 2: A 27-year-old female with PCOS presented with eruptive xanthoma and severe hyperlipidaemia (triglyceride 140 mmol/l, cholesterol 42 mmol/l), requiring plasmapheresis.
  • The second patient had concurrent diabetes, oral contraceptive use, and apolipoprotein CII deficiency, complicating her lipid management.

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Findings:

  • In both cases, the onset of diabetes was preceded by hypertriglyceridemia.
  • Good glycemic control in the first patient led to a minimization of hypertriglyceridemia.
  • The second patient's severe hyperlipidaemia was managed with plasmapheresis and insulin therapy for diabetes.

Implications:

  • These cases emphasize the critical relationship between diabetes and severe hypertriglyceridemia, suggesting that managing diabetes is key to controlling triglyceride levels.
  • The complex case of the young female highlights the multifactorial nature of severe hypertriglyceridemia, involving genetic factors (apolipoprotein deficiency), hormonal influences (PCOS, oral contraceptives), and metabolic disease (diabetes).
  • Further research into the specific mechanisms linking these conditions may lead to improved therapeutic strategies for patients with both hypertriglyceridemia and diabetes.