Key result
Severe refractory HTG despite good glycemic control indicates a primary genetic cause like familial chylomicronemia syndrome.
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Severe hypertriglyceridemia unresponsive to standard therapy and good glycemic control in a diabetic patient should prompt investigation for primary genetic causes like familial chylomicronemia syndrome.
Diabetes mellitus is a common cause of secondary hypertriglyceridemia. However, lipemic plasma with severe hypertriglyceridemia, limited response to strict dietary measures, commonly used pharmacotherapy, and good glycemic control, should raise suspicion of a primary cause. Positive family history and genetic studies can give a diagnosis of familial dyslipidemia syndromes.
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Sankhi et al. (2026) studied this question. Severe hypertriglyceridemia resistant to standard therapy despite good glycemic control indicates a primary genetic cause like familial chylomicronemia syndrome.
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