Background: The risk of pancreatitis increases when triglyceride levels rise above 1 000 mg/dl. This requires particular attention in subjects with type 2 diabetes, which is accompanied by elevated triglyceride levels in one in every two patients. Apheresis, a treatment option in pancreatitis developing secondary to hypertriglyceridemia, is expensive and not available in every centre. Another option, heparin administration, may result in rebound hypertriglyceridaemia. Thirdly, continuous insulin infusion is an alternative option in these patients.
Case presentation: Continuous insulin infusion was applied in the treatment of pancreatitis developing secondary to severe hypertriglyceridemia (6 695 mg/dl) in an adolescent who had been diagnosed with type 2 diabetes several years previously but had been left untreated. He was screened for lipoprotein lipase mutation and no mutation was detected. At the 14th h of infusion, triglyceride levels decreased by 80% (to 1 110 mg/dl), with no complications.
Conclusion: Insulin infusion is an inexpensive, fast and safe form of treatment in severe hypertriglyceridaemia induced pancreatitis.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology