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A 45-year-old woman presented with type V phenotype, mixed hyperlipemia and secondary type 2 diabetes mellitus. Her diseases were managed with insulin and oral hypoglycemic agents with combined n–3 fatty acids–orlistat–fibrate–statin lipid-lowering therapy. Despite intensive therapy, the total triglyceride level was typically 4000 mg per deciliter (45 mmol per liter) but ranged up to 26,550 mg per deciliter (300 mmol per liter), the glucose level was 200 to 300 mg per deciliter (11 to 17 mmol per liter), and the glycosylated hemoglobin value was 13 percent. The fibrate-stimulated lipoprotein lipase activity was 0.5 percent of normal. On physical examination, she . . . [Full Text of this Article] |
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