Reduction in Serum Triglyceride Levels in Diabetic Patients May Result in Decreased Insulin Dependence and Disease Regression.

BACKGROUND: Type 2 diabetes mellitus is a multifactorial disease in which genetic susceptibility and environmental factors induce pancreatic β-cell dysfunction and insulin resistance. Additional factors such as hyperglycemia and hyperlipidemia have roles in β-cell dysfunction and disease progression. The phenomenon of lipid-induced pancreatic β-dysfunction, designated as lipotoxicity, has been observed in several in vitro and in vivo experiments; however, there is still no solid evidence for the occurrence of this event in humans. The toxic effect of high lipid levels on β-cell function consists of impaired insulin gene expression, apoptosis, and reduced glucose-stimulated insulin secretion. OBJECTIVES: To demonstrate the importance of treating hypertriglyceridemia in reducing glucose intolerance and the need for insulin therapy in hospitalized diabetic patients. METHODS: We evaluated five clinical case reports and conducted a detailed literature review via the PubMed search engine. RESULTS: Reduction in elevated blood triglyceride and glucose levels in hospitalized diabetic patients resulted in a rapid decline in glucose levels and in the need for insulin therapy. CONCLUSIONS: A decrease in high triglyceride levels in "lipotoxic" diabetic patients may improve insulin intolerance and glucose homeostasis and reduce the need for insulin therapy.