Laboratory results for a patient with uncontrolled Type I diabetes reveal hyperglycemia (634 mg/dL) and hypertriglyceridemia (498 mg/dL). Which of the following represents the most likely cause of the hypertriglyceridemia in this patient?

Question

Quizplus · Accepted Answer

In uncontrolled Type I diabetes, insulin deficiency leads to decreased lipoprotein lipase activity, which is necessary for the breakdown of triglycerides in chylomicrons and VLDL, resulting in hypertriglyceridemia.  The triacylglyceride components of VLDL and chylomicron are hydrolyzed to free fatty acids and glycerol in the capillaries of tissues such as liver, adipose tissue, and skeletal muscle by the actions of lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL). Insulin exerts numerous effects on overall metabolic homeostasis. One of the effects of insulin that relate to the symptoms in this patient is the regulation of the expression of LPL on the surface of endothelial cells. Since Type 1 diabetics do not synthesize insulin they do not properly regulate the level of LPL which contributes to hypertriglyceridemia in these individuals.

Laboratory Results for a Patient with Uncontrolled Type I Diabetes