Severe hyperlipemia in a young child with diabetic ketoacidosis

Hypertriglyceridemia is common in poorly controlled diabetes. Triglyceride levels above 2000 mg/dl may result from an underlying genetic hyperlipemia, especially in patients with type 2 diabetes. Severe hyperlipemia with milky plasma has been described also at the onset of type 1 diabetes, but in this case it is usually transient. We report the case of a young child with massive hyperlipemia during ketoacidosis. No mutation of candidate genes was found. A transient lipoprotein lipase defect induced by insulin deficiency, in addition to insulin resistance, contributed to determine hyperlipemia.