title: Strawberry milk-like blood in a subject with diabetic lipemia: dramatic change to transparent color after insulin therapy.
abstract: BACKGROUND
  It is known that chylomicronemia is caused by several pathologies and is classified as primary and secondary chylomicronemia. Since hypertriglycemia is associated with an increased risk of cardiovascular disease and severe pancreatitis, it is very important to make a proper diagnosis of the cause of hypertriglycemia.
  
  
  METHODS
  We herein present the case of a 40-year-old male who developed severe hypertriglycemia accompanied with acute exacerbation of type 2 diabetes mellitus. On admission, his blood glucose level was 306 mg/dl and HbA1c was 12.5 %. Moreover, serum triglyceride level was elevated up to 5661 mg/dl. When blood was drawn, it presented strawberry milk-like color. After receiving insulin treatment, he obtained good glycemic control and the serum became back to normal transparent color.
  
  
  RESULTS
  Insulin resistance reduces triglyceride clearance and also increases triglyceride release from adipocyte. It is known that glucose toxicity and strong insulin resistance induce inactivation of LPL, which results in chylomicronemia.
  
  
  CONCLUSIONS
  This case report suggests that when serum triglyceride level is markedly elevated due to diabetic lipemia, it is extremely important to obtain good glycemic control.
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Obata
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kamei
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Seizo
authors.initials: S
authors.lastname: Okauchi
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hirukawa
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tanabe
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Tomoe
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kohara
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Tatsumi
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Shimoda
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nakanishi
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Mune
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Kaku
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneto
keywords: Chylomicronemia; Diabetic lipemia; Hypertriglycemia