Abstract
A 36-year-old woman with juvenile diabetes mellitus was admitted to the hospital because of nausea and severe abdominal pain. The patient had been treated with 36-60 units of lente insulin. However, her diabetes had been not only poorly controlled but also complicated by diabetic retinopathy (Scott IV).
On admission, her serum was milky. Her blood sugar was 454mg per 100ml, total lipids 20, 843 mg per 100m, triglycerides 11, 670mg per 100ml, cholesterol 1, 383mg per 100ml, and phos. pholipid 1, 334mg per 100ml. The serum lipoprotein by electrophoretic pattern was characterized by increased chylomicron (19%) and pre-β lipoprotein (51%) fractions.
It was concluded that this was a case of severe secondary hyperlipoproteinemia accompanied by poorly controlled diabetes mellitus, and that the mechanism of this hyperlipoproteinemia was largely the result of a disturbance in the removal of liver synthesized triglycerides with the increased amounts of mobilized adipose tissue fatty acids caused by chronic insulin insufficiency. The abdominal pain on admission might have due to transient fat emboli in small blood vessels by severe hyperlipemia.
