A Case of Diabetic Lipemia at the Onset of Type 1 Diabetes Mellitus in 4-Year-Old Girl

Abstract

A four-year-old girl was referred to our department for hyperglycemia and ketosis after six months of fatigue, polydipsia, and polyuria. She had ketosis and mild metabolic acidosis; laboratory tests demonstrated that her serum glucose was 530 mg/dL, HbA1c was 16.9 %, and serum triglyceride was as high as 6,915 mg/dL. We performed an analysis of her lipoprotein cholesterol levels, which revealed a high level of very-low-density lipoprotein cholesterol, leading to the diagnosis of diabetic lipemia. The hypertriglyceridemia was improved shortly after the initiation of insulin therapy without a complication of acute pancreatitis. Predisposing factors of diabetic lipemia may include a long duration of insulin insufficiency and decreased activity of lipoprotein lipase. We should therefore be alert for the possibility of patients presenting with diabetic lipemia, even in pediatric practice, as it may cause severe complications, such as acute pancreatitis.