Subcutaneous NPH Insulin for Severe Hypertriglyceridemia in a Pregnant Patient with Type V Hyperlipoproteinemia: a Case Report

Abstract

An increase in triglyceride levels in familial hyperlipidemia during pregnancy has been reported. Severe hypertriglyceridemia can lead to complications such as acute pancreatitis, preeclampsia, maternal and fetal complications. Because of the teratogenic effects associated with fibrate therapy in pregnancy, alternative treatment strategies such as insulin as a rapid and potent activator of lipoprotein lipase are required during pregnancy. We report a case of hypertriglyceridemia in a 33-year-old pregnant woman in whom treatment with merely single one time administration of Neutral Protamine Hagedorn insulin was accompanied by a reduction in the serum triglyceride level; to the best of our knowledge, this has never been reported in the literature. Her triglyceride level was 3616 mg/dL before insulin treatment and 1246 mg/dL after insulin treatment. Although this regimen was used safely and effectively in our patient, comprehensive studies are required to evaluate the effectiveness and safety of subcutaneously intermediate-acting Neutral Protamine Hagedorn insulin for the treatment of severe hypertriglyceridemia in non-diabetic pregnant women. Turkish Başlık: Tip V Hiperlipoproteinemili Gebe Bir Hastada Şiddetli Hipertrigliseridemi İçin Verilen Subkutan NPH Insulin Tedavisi: Vaka Sunumu Anahtar Kelimeler: Hamilelik, hipertrigliseridemi, insülin Gebelerde ve familyal hiperlipidemilerde gebelik sırasında trigliserit düzeylerinde artış olmaktadır. Şiddetli hipertrigliseridemi akut pankreatit, preeklampsi, anne ve bebekte komplikasyonlara yol açabilir. Gebelik döneminde fibrat tedavisinin teratojenik etkilerinden dolayı, lipoprotein lipazın hızlı ve güçlü bir aktivatörü olan insulin gibi alternatif tedavi yöntemleri gerekebilir. Biz, serum trigliserid düzeylerini azaltmak amacı ile sadece tek doz Nötral Protamin Hadegorn insulin ile tedavi ettiğimiz, literatürde daha önceden rapor edilmemiş 33 yaşında hipertrigliseridemisi olan gebe bir hastayı bildirdik. Hastanın insulin tedavi öncesi trigliserid düzeyi 3616 mg/dl iken tedavi sonrası 1246 mg/dl oldu. Bu tedavi rejimi hastamızda etkili ve güvenli olmasına karşın, diyabetik olmayan şiddetli hipertrigliseridemik gebelerde subkutan yolla verilen orta etkili Nötral Protamin Hadegorn insülinin etkinliğini ve güvenilirliğini değerlendirecek kapsamlı çalışmalara gerek vardır

Keywords

• Pregnancy, hypertriglyceridemia, insulin

Subcutaneous NPH Insulin for Severe Hypertriglyceridemia in a Pregnant Patient with Type V Hyperlipoproteinemia: a Case Report

Öz

Kaynakça

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13. NPH Insulin Treatment for Severe Hypertriglyceridemia in a Pregnant Patient