Severe hypertriglyceridaemia in Type 2 diabetes mellitus: beneficial effect of continuous insulin infusion
| Autor: | Omar G Mustafa, M A Crook, J Miell, S R Henderson, S R Kottegoda, R Maitland |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases medicine.medical_treatment Gastroenterology Drug Administration Schedule Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin Infusions Intravenous Adverse effect Triglycerides Aged Retrospective Studies Hypertriglyceridemia business.industry nutritional and metabolic diseases Type 2 Diabetes Mellitus General Medicine Middle Aged medicine.disease Surgery Treatment Outcome Diabetes Mellitus Type 2 Hyperglycemia Drug Evaluation Pancreatitis Acute pancreatitis Female Complication business |
| Zdroj: | QJM. 106:355-359 |
| ISSN: | 1460-2393 1460-2725 |
| DOI: | 10.1093/qjmed/hcs238 |
| Popis: | Background: Severe hypertriglyceridaemia is a recognized complication of Type 2 diabetes mellitus (T2DM); however, there is no consensus on acute management despite the significant risk of developing associated complications such as acute pancreatitis and hyperviscosity syndrome. Aim: To identify the association between hyperglycaemia and severe hypertriglyceridaemia in patients with T2DM and assess the effect of continuous insulin infusion therapy on serum triglyceride (TG) concentrations and report any adverse events associated with this therapeutic approach. Design: Retrospective review of case records. Methods: Patients with uncontrolled hyperglycaemia and severe hypertriglyceridaemia (serum TG > 15 mmol/l) treated with continuous intravenous insulin infusion between October 2008 and September 2009 were retrospectively evaluated ( n = 15). Details recorded included demographics, admission details, lipid profiles, glycaemic control, serum amylase and adverse events. Patients receiving treatment-dose unfractionated heparin infusion were excluded. Results: Severe hypertriglyceridaemia is associated with hyperglycaemia in our heterogeneous group of patients with T2DM presenting with new-onset diabetes or established disease on pre-existing insulin or oral hypoglycaemic agents. Administration of continuous exogenous insulin not only achieved normoglycaemia but also dramatically corrected severe hypertriglyceridaemia in all patients ( P = 0.001). Conclusions: The administration of continuous insulin in patients with T2DM with severe hypertriglyceridaemia is a simple and safe method of significantly reducing the immediate risk associated with this metabolic complication and should be considered in any T2DM patient presenting with severe hypertriglyceridaemia and hyperglycaemia. |
| Databáze: | OpenAIRE |
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