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Rapid reduction of severely elevated serum triglycerides with insulin infusion, gemfibrozil and niacin.
Clin Med Res. 2011 Mar; 9(1):38-41.CM

Abstract

The conventional methods of treatment of severe hypertriglyceridemia are dietary restriction and lipid lowering medications, mainly fibric acid derivatives. In the medical literature, use of insulin infusion to treat hypertriglyceridemia has not been highlighted sufficiently. We report a 53-year-old male who presented with a four-day history of epigastric pain. The patient's clinical history was significant for hypertriglyceridemia, type-2 diabetes mellitus with medication noncompliance, obesity, status post-gastric bypass surgery, and alcohol abuse with prior admissions for detoxification. Physical examination revealed mild epigastric tenderness. Laboratory studies revealed severely elevated serum triglyceride (TG) level (8116 mg/dL). Computed tomography (CT) scan of the abdomen exhibited no evidence of pancreatitis. Regular insulin infusion was started at 3 U/h and gradually increased to 7-10 U/h. Dextrose infusion was titrated to avoid hypoglycemia and maintain blood glucose levels below 150 mg/dL. Gemfibrozil and niacin were also started. After 24 hours, his TG levels were decreased to 2501 mg/dL. Insulin infusion was continued for about 48 hours. A low carbohydrate diet excluding simple carbohydrates was given. The patient's serum TG levels normalized over a period of one month. Thus insulin infusion can be considered a safe modality of treatment for rapid reduction of serum TG in addition to fibrates and niacin.

Authors+Show Affiliations

Department of Internal Medicine, Marshfield Clinic, WI, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20852089

Citation

Poonuru, Sujani, et al. "Rapid Reduction of Severely Elevated Serum Triglycerides With Insulin Infusion, Gemfibrozil and Niacin." Clinical Medicine & Research, vol. 9, no. 1, 2011, pp. 38-41.
Poonuru S, Pathak SR, Vats HS, et al. Rapid reduction of severely elevated serum triglycerides with insulin infusion, gemfibrozil and niacin. Clin Med Res. 2011;9(1):38-41.
Poonuru, S., Pathak, S. R., Vats, H. S., & Pathak, R. D. (2011). Rapid reduction of severely elevated serum triglycerides with insulin infusion, gemfibrozil and niacin. Clinical Medicine & Research, 9(1), 38-41. https://doi.org/10.3121/cmr.2010.898
Poonuru S, et al. Rapid Reduction of Severely Elevated Serum Triglycerides With Insulin Infusion, Gemfibrozil and Niacin. Clin Med Res. 2011;9(1):38-41. PubMed PMID: 20852089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid reduction of severely elevated serum triglycerides with insulin infusion, gemfibrozil and niacin. AU - Poonuru,Sujani, AU - Pathak,Sumedha R, AU - Vats,Hemender S, AU - Pathak,Ram D, Y1 - 2010/09/17/ PY - 2010/9/21/entrez PY - 2010/9/21/pubmed PY - 2011/7/19/medline SP - 38 EP - 41 JF - Clinical medicine & research JO - Clin Med Res VL - 9 IS - 1 N2 - The conventional methods of treatment of severe hypertriglyceridemia are dietary restriction and lipid lowering medications, mainly fibric acid derivatives. In the medical literature, use of insulin infusion to treat hypertriglyceridemia has not been highlighted sufficiently. We report a 53-year-old male who presented with a four-day history of epigastric pain. The patient's clinical history was significant for hypertriglyceridemia, type-2 diabetes mellitus with medication noncompliance, obesity, status post-gastric bypass surgery, and alcohol abuse with prior admissions for detoxification. Physical examination revealed mild epigastric tenderness. Laboratory studies revealed severely elevated serum triglyceride (TG) level (8116 mg/dL). Computed tomography (CT) scan of the abdomen exhibited no evidence of pancreatitis. Regular insulin infusion was started at 3 U/h and gradually increased to 7-10 U/h. Dextrose infusion was titrated to avoid hypoglycemia and maintain blood glucose levels below 150 mg/dL. Gemfibrozil and niacin were also started. After 24 hours, his TG levels were decreased to 2501 mg/dL. Insulin infusion was continued for about 48 hours. A low carbohydrate diet excluding simple carbohydrates was given. The patient's serum TG levels normalized over a period of one month. Thus insulin infusion can be considered a safe modality of treatment for rapid reduction of serum TG in addition to fibrates and niacin. SN - 1554-6179 UR - https://www.unboundmedicine.com/medline/citation/20852089/Rapid_reduction_of_severely_elevated_serum_triglycerides_with_insulin_infusion_gemfibrozil_and_niacin_ L2 - http://www.clinmedres.org/cgi/pmidlookup?view=long&pmid=20852089 DB - PRIME DP - Unbound Medicine ER -