Insulin therapy for a non-diabetic patient with severe hypertriglyceridemia.
OBJECTIVE
To compare the short and long term effectiveness of fish oil, insulin, and gemfibrozil in a non-diabetic patient with severe hypertriglyceridemia.


METHODS
An adolescent male with hypertriglyceridemia (triglyceride level 4575 mg/dl) and abdominal pain was treated with the goal of immediate reduction and maintenance of triglyceride (TG) level below 1000 mg/dl. Fish oil, insulin and gemfibrozil were administered sequentially, in separate time blocks, for a duration of 3, 6, and 6 months, respectively.


RESULTS
Fish oil took several weeks to lower TG level, and patient compliance during 3 months of therapy was inadequate. Insulin was effective in immediately lowering the TG level, but was unable to maintain the level below 1000 mg/dl. Gemfibrozil was ineffective in achieving the immediate reduction of TG level; however, it was adequate in maintaining the desired level in the long-term and patient compliance was better than with the fish oil.


CONCLUSIONS
In patients with risk of pancreatitis due to severe hypertriglyceridemia, immediate reduction of the triglyceride level is achievable by using a single dose of regular insulin (0.1 unit/kg, subcutaneous) while long-term maintenance therapy can be provided by gemfibrozil.
Jabbar
M A
MA
Department of Pediatrics, Hurley Medical Center-Michigan State University, Flint 48502, USA.
Zuhri-Yafi
M I
MI
Larrea
J
J
D015746:Abdominal Pain; D000293:Adolescent; D002784:Cholesterol / Q000097:blood; D005395:Fish Oils / Q000008:administration & dosage / Q000627:therapeutic use; D015248:Gemfibrozil / Q000627:therapeutic use; D006801:Humans; D015228:Hypertriglyceridemia / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D011627:Puberty; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D005395:Fish Oils; D000960:Hypolipidemic Agents; D007328:Insulin; D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol; D015248:Gemfibrozil