Treatment of hypertriglyceridemia-induced acute pancreatitis with insulin

Abstract

Introduction: Hypertriglyceridaemia (HT)-induced pancreatitis rarely occurs unless triglyceride levels exceed 1000 mg/dl. Hypertriglyceridaemia over 1,000 mg/dl can provoke acute pancreatitis (AP) and its persistence can worsen the clinical outcome. In contrast, a rapid decrease in triglyceride level is beneficial. Insulin-stimulated lipoprotein lipase is known to decrease serum triglyceride levels. However, their efficacy in HT-induced AP is not well documented.

Aim: To present 12 cases of AP successfully treated by insulin administration.

Material and methods: Three hundred and forty-three cases of AP were diagnosed at our clinic between 2005 and 2012. Twelve (3.5%) of these cases were HT-induced AP. Twelve patients who suffered HT-induced AP are reported. Initial blood triglyceride levels were above 1000 mg/dl. Besides the usual treatment of AP, insulin was administered intravenously in continuous infusion. The patients' medical records were retrospectively evaluated in this study.

Results: Serum triglyceride levels decreased to < 500 mg/dl within 2-3 days. No complications of treatment were seen and good clinical outcome was observed.

Conclusions: Our results are compatible with the literature. Insulin may be used safely and effectively in HT-induced AP therapy. Administration of insulin is efficient when used to reduce triglyceride levels in patients with HT-induced AP.

Keywords: acute pancreatitis; hyperlipidaemia; hypertriglyceridemia; insulin.