Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale

Drinking fruit juice is an increasingly popular health trend, as it is widely perceived as a source of vitamins and nutrients. However, high fructose load in fruit beverages can have harmful metabolic effects. When consumed in high amounts, fructose is linked with hypertriglyceridemia, fatty liver a...

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Autores principales:	Ana Dugic, Michael Kryk, Claudia Mellenthin, Christoph Braig, Lorenzo Catanese, Sandy Petermann, Jürgen Kothmann, Steffen Mühldorfer
Formato:	article
Lenguaje:	EN
Publicado:	Bioscientifica 2021
Materias:	Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/38f22a339e67433d985c7a8c94d4ce8c
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spelling	oai:doaj.org-article:38f22a339e67433d985c7a8c94d4ce8c2021-11-10T12:29:14ZFructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale10.1530/EDM-21-01102052-0573https://doaj.org/article/38f22a339e67433d985c7a8c94d4ce8c2021-11-01T00:00:00Zhttps://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0110.xmlhttps://doaj.org/toc/2052-0573Drinking fruit juice is an increasingly popular health trend, as it is widely perceived as a source of vitamins and nutrients. However, high fructose load in fruit beverages can have harmful metabolic effects. When consumed in high amounts, fructose is linked with hypertriglyceridemia, fatty liver and insulin resistance. We present an unusual case of a patient with severe asymptomatic hypertriglyceridemia (triglycerides of 9182 mg/dL) and newly diagnosed type 2 diabetes mellitus, who reported a daily intake of 15 L of fruit juice over several weeks before presentation. The patient was referred to our emergency department with blood glucose of 527 mg/dL and glycated hemoglobin (HbA1c) of 17.3%. Interestingly, features of diabetic ketoacidosis or hyperosmolar hyperglycemic state were absent. The patient was overweight with an otherwise unremarkable physical exam. Lipase levels, liver function tests and inflammatory markers were closely monitored and remained unremarkable. The initial therapeutic approach included i.v. volume resuscitation, insulin and heparin. Additionally, plasmapheresis was performed to prevent potentially fatal complications of hypertriglyceridemia. The patient was counseled on balanced nutrition and detrimental effects of fruit beverages. He was discharged home 6 days after admission. At a 2-week follow-up visit, his triglyceride level was 419 mg/dL, total cholesterol was 221 mg/dL and HbA1c was 12.7%. The present case highlights the role of fructose overconsumption as a contributory factor for severe hypertriglyceridemia in a patient with newly diagnosed diabetes. We discuss metabolic effects of uncontrolled fructose ingestion, as well as the interplay of primary and secondary factors, in the pathogenesis of hypertriglyceridemia accompanied by diabetes.Ana DugicMichael KrykClaudia MellenthinChristoph BraigLorenzo CataneseSandy PetermannJürgen KothmannSteffen MühldorferBioscientificaarticleDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENEndocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	Diseases of the endocrine glands. Clinical endocrinology RC648-665 Ana Dugic Michael Kryk Claudia Mellenthin Christoph Braig Lorenzo Catanese Sandy Petermann Jürgen Kothmann Steffen Mühldorfer Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
description	Drinking fruit juice is an increasingly popular health trend, as it is widely perceived as a source of vitamins and nutrients. However, high fructose load in fruit beverages can have harmful metabolic effects. When consumed in high amounts, fructose is linked with hypertriglyceridemia, fatty liver and insulin resistance. We present an unusual case of a patient with severe asymptomatic hypertriglyceridemia (triglycerides of 9182 mg/dL) and newly diagnosed type 2 diabetes mellitus, who reported a daily intake of 15 L of fruit juice over several weeks before presentation. The patient was referred to our emergency department with blood glucose of 527 mg/dL and glycated hemoglobin (HbA1c) of 17.3%. Interestingly, features of diabetic ketoacidosis or hyperosmolar hyperglycemic state were absent. The patient was overweight with an otherwise unremarkable physical exam. Lipase levels, liver function tests and inflammatory markers were closely monitored and remained unremarkable. The initial therapeutic approach included i.v. volume resuscitation, insulin and heparin. Additionally, plasmapheresis was performed to prevent potentially fatal complications of hypertriglyceridemia. The patient was counseled on balanced nutrition and detrimental effects of fruit beverages. He was discharged home 6 days after admission. At a 2-week follow-up visit, his triglyceride level was 419 mg/dL, total cholesterol was 221 mg/dL and HbA1c was 12.7%. The present case highlights the role of fructose overconsumption as a contributory factor for severe hypertriglyceridemia in a patient with newly diagnosed diabetes. We discuss metabolic effects of uncontrolled fructose ingestion, as well as the interplay of primary and secondary factors, in the pathogenesis of hypertriglyceridemia accompanied by diabetes.
format	article
author	Ana Dugic Michael Kryk Claudia Mellenthin Christoph Braig Lorenzo Catanese Sandy Petermann Jürgen Kothmann Steffen Mühldorfer
author_facet	Ana Dugic Michael Kryk Claudia Mellenthin Christoph Braig Lorenzo Catanese Sandy Petermann Jürgen Kothmann Steffen Mühldorfer
author_sort	Ana Dugic
title	Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
title_short	Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
title_full	Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
title_fullStr	Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
title_full_unstemmed	Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
title_sort	fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale
publisher	Bioscientifica
publishDate	2021
url	https://doaj.org/article/38f22a339e67433d985c7a8c94d4ce8c
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Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale

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