NON-INSULIN DEPENDENT DIABETES MELLITUS COMPLICATED WITH SEVERE TYPE V HYPERLIPIDEMIA

The case of 41 year-old man with non-insulin dependent diabetes mellitus and severe type V hyperlipidemia is reported. On admission, the fasting plasma glucose was 157 mg/dl and Hb A1c 9.8%. The serum total cholesterol was 638 mg/dl, triglyceride 2, 779 mg/dl, apoprotein (apo) A-I 174 mg/dl, apo A-II 86.9 mg/dl, apo B 475 mg/dl and apo E 28.2 mg/dl. Agar gel electrophoresis revealed increased chylomicron and beta lipoprotein. The serum apoproteins were normalized by diet therapy. However, the oral administration of 75 g of olive oil induced a marked increase in the serum triglyceride even with good control of the diabetes by appropriate diet. We postulate that insufficient chylomicron receptor may be responsible for the abnormalities of serum lipids in this patient.