Diabetic Ketoacidosis, Very Severe Hypertriglyceridemia, and Pseudohyponatremia Successfully Managed With Insulin Infusion

Hypertriglyceridemia is a common lipid abnormality that has serious consequences, such as acute pancreatitis and premature atherosclerosis. The consensus for first-line treatment to lower the triglyceride levels has not been fully evaluated. We present a case of very severe hypertriglyceridemia with diabetic ketoacidosis and an artifactual pseudohyponatremia. The patient was effectively and safely treated with guideline-directed medical therapy; however, it needed a longer duration of intravenous insulin. Therefore, our case has been in agreement with literature by concluding that insulin is in fact an effective and minimally invasive form to lower a high triglyceride level, especially in patients who have concurrent uncontrolled diabetes mellitus.