Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
-
Tyler Fick
,
Julie Jack
Abstract
Background:
Severe hypertriglyceridemia (HTG) as well as diabetic ketoacidosis (DKA) are complications of type 1 diabetes (T1DM). HTG is an exceedingly rare complication in the pediatric population and herein we report a case of HTG at new-onset T1DM in DKA and discuss management and potential complications.
Case presentation:
An 11-year-old previously well patient with a history of fatigue and weight loss presented with: glucose >600 mg/dL, venous blood gas: pH 7.26, pCO2 20 mmHg, PO2 101 mmHg and base deficit 13 with triglyceride level 3573 mg/dL. An insulin drip was continued past criteria for discontinuation to facilitate lipoprotein lipase-based triglyceride metabolism.
Conclusions:
Lipemia secondary to severe HTG, though exceedingly rare, may exist in new onset T1DM with DKA. Complicating the diagnosis is the possibility of an analytical error from lipemia causing incongruence in diagnostic criteria. Clinicians should rely on clinical criteria for management and should consider HTG if laboratory data is inconsistent with the clinical picture.
Author contributions: Tyler Fick carried out initial analyses and drafted the manuscript. Julie Jack carried out initial analyses and contributed to the manuscript. Amy Pyle-Eilola reviewed laboratory data and contributed to the manuscript. Rohan Henry conceptualized the study, carried out initial analyses, reviewed and revised the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethics Statement and patient consent: This report was written with patient identifiers removed as much as possible but to elucidate pertinent material from the case. Per institutional review board guidelines based on our home institutional guidelines, verbalization of the publication made aware to the family and they were in accords with this plan without concern.
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Articles in the same Issue
- Frontmatter
- Editorial
- Endocrine aspects in cystic fibrosis
- Original Articles
- A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
- Cystic-fibrosis related-diabetes (CFRD) is preceded by and associated with growth failure and deteriorating lung function
- Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of <0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission
- Concentrations of leptin, adiponectin and other metabolic parameters in non-obese children with Down syndrome
- Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children
- Multinodular goiter in children: treatment controversies
- Atopy as a risk factor for subclinical hypothyroidism development in children
- Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism
- Health-related quality of life among children with Turner syndrome: controlled cross-sectional study
- Growth and pubertal patterns in young survivors of childhood acute lymphoblastic leukemia
- Clinical features and genotyping of patients with primary carnitine deficiency identified by newborn screening
- Letter to the Editor
- Sensitivity and specificity of cystic fibrosis-related diabetes screening methods: which test should be the reference method?
- Case Reports
- Type 1 rhizomelic chondrodysplasia punctata with a homozygous PEX7 mutation
- Severe hypertriglyceridemia at new onset type 1 diabetes mellitus
- 45,X/46,XY ovotesticular disorder of sex development revisited: undifferentiated gonadal tissue may be mistaken as ovarian tissue
- MRI in medium-chain acyl-coenzyme a dehydrogenase deficiency: neuroimaging during the first month
