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Betul Erismis

Sadi Konuk Training and Research Hospital, Turkey

Title: Management of Hypertriglyceridemia in Uncontrolled Type 2 Diabetes Mellitus Patients ; 2 Case Study

Biography

Biography: Betul Erismis

Abstract

Introduction: One of the known cause of hypertriglycerimidemia(HTG) is Type 2 diabetes mellitus(DM). We aimed to present two uncontrolled type 2 DM  associated with severe HTG who were treated succesfully with insulin infusion. Case 1: A thirty-two-year-old woman previously healthy, was admitted to our outpatient clinic because of abdominal pain and polydipsia. Her physical examination was normal. Her laboratory investigations  showed a fasting  glucose (FG) 35 mg/dL, triglyceride (TGC) 1316mg/dL, C-peptide 0,78mg/dL, HbA1c %14,7, pH: 7.35,  ketonuria and glycosuria. Her serum amylase and lipase levels were 27 U/L and  26 U/L respectively. There was no signs of acute pancreatitis (AP) on radiological examinations. Intravenous fluid therapy and continous insulin perfusion started to decrease glucose levels. With this treatment her TGC levels decreased as well. At 48th hour it dropped to 199mg/dL. To exclude type 1 DM; insulin and anti GAD antibodies were negative. Later her glycemic control was continued with subcutaneous intensive insulin. After achieving glycemic control, she had no recurrence of  HTG during her follow-up visits. Case 2: A second case of  52 years old woman with type 2 DM and severe HTG. Before 5 years she had an attack of AP (3 years after diagnosis of DM). Her FG, TGC, and HbA1c were 393mg/dL, 9283mg/dL, and 14%, respectively. She also had ketonuria and glycosuria but no acidosis. AP attack was excluded and insulin infusion started. There was a progressive decrease in her  TGC levels (380mg/dL at the 6th day of insulin treatment). Behind subcutaneous insulin therapy, omega 3 fatty acids and fibrate treatment were started too at discharge of hospital. After 3 months of follow-up, her TGC was 200mg/dL. Conclusion: Lowering blood sugar in DM may lower the increased TGC levels as well. Bearing in mind this point may help in managing DM assocaited HTG.