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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2021-11-01
|
| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0110.xml |
| _version_ | 1818983690975313920 |
|---|---|
| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-20T18:07:08Z |
| format | Article |
| id | doaj.art-38f22a339e67433d985c7a8c94d4ce8c |
| institution | Directory Open Access Journal |
| issn | 2052-0573 |
| language | English |
| last_indexed | 2024-12-20T18:07:08Z |
| publishDate | 2021-11-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-38f22a339e67433d985c7a8c94d4ce8c2022-12-21T19:30:33ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732021-11-01111610.1530/EDM-21-0110Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary taleAna Dugic0Michael Kryk1Claudia Mellenthin2Christoph Braig3Lorenzo Catanese4Sandy Petermann5Jürgen Kothmann6Steffen Mühldorfer7Department for Gastroenterology, Endocrinology and Metabolic Diseases, Bayreuth University Hospital, Friedrich- Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDepartment for Gastroenterology, Endocrinology and Metabolic Diseases, Bayreuth University Hospital, Friedrich- Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDepartment of Surgery, HFR Fribourg, Fribourg, SwitzerlandDepartment for Gastroenterology, Endocrinology and Metabolic Diseases, Bayreuth University Hospital, Friedrich- Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDepartment for Nephrology, Angiology and Rheumatology, Bayreuth University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDepartment for Gastroenterology, Endocrinology and Metabolic Diseases, Bayreuth University Hospital, Friedrich- Alexander University Erlangen-Nuremberg, Bayreuth, GermanDepartment for Nephrology, Angiology and Rheumatology, Bayreuth University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDepartment for Gastroenterology, Endocrinology and Metabolic Diseases, Bayreuth University Hospital, Friedrich- Alexander University Erlangen-Nuremberg, Bayreuth, GermanyDrinking 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.https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0110.xml |
| spellingShingle | 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 Endocrinology, Diabetes & Metabolism Case Reports |
| title | 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_short | Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale |
| title_sort | fructose induced severe hypertriglyceridemia and diabetes mellitus a cautionary tale |
| url | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM21-0110.xml |
| work_keys_str_mv | AT anadugic fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT michaelkryk fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT claudiamellenthin fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT christophbraig fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT lorenzocatanese fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT sandypetermann fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT jurgenkothmann fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale AT steffenmuhldorfer fructoseinducedseverehypertriglyceridemiaanddiabetesmellitusacautionarytale |