Why the study?
Does insulin infusion reduce triglyceride levels and improve clinical outcomes in patients with severe acute pancreatitis secondary to hypertriglyceridemia?
Does insulin infusion reduce triglyceride levels and improve clinical outcomes in patients with severe acute pancreatitis secondary to hypertriglyceridemia?
Insulin infusion may be an effective therapeutic strategy to rapidly reduce triglyceride levels in patients with severe acute pancreatitis secondary to hypertriglyceridemia.
May support insulin for triglyceride reduction in hypertriglyceridemic pancreatitis; hypothesis-generating and requires prospective trials before practice change.
Acute pancreatitis is a reversible inflammatory process. Hypertriglyceridemia as a cause of acute pancreatitis reaches frequencies of 1.3-11% according to the literature when triglyceride levels reach values over 1,000 mg/dl; nevertheless hypertriglyceridemia is observed in 12-39% of acute pancreatitis cases as an associated factor. The objective of medical treatment is to increase lipoprotein-lipase activity, and to increase chylomicron breakdown thus diminishing serum triglycerides to levels smaller than 500 or even 200 mg/dl (when possible) using a variety of strategies including insulin administration. In the present article, we report two cases of severe pancreatitis induced by hypertriglyceridemia that were managed with insulin infusion; both responded adequately, as measured by a significant reduction of triglyceride levels at 48 hours post-treatment.
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Forero et al. (2008) studied this question.
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