I have at least 6 patients who have been referred to the lipid clinic due to pancreatitis due to massive hypertrig. The risk is not entirely due to hypertrig though: DIabetics are more resistant to pancreatitis than alcoholics - so there is definitely something more to the aetiology.
2) All diabetics should have a lipid profile not just cholesterol [and it doesn't have to be fasting because although a trig of 4 may be due to breakfast a trig of 20 won't be] - This allows informed choice of statin vs. fibrate because despite claims of some statin manufacturers that their product works wonderfully with high trigs, this really only applies to trigs up to 4 and beyond that a statin fibrate combination is often necessary.
TIM
**************************************************************************
Prof. Tim Reynolds,
Clinical chemistry Dept.,
Queen's Hospital,
Belvedere Rd.,
Burton-on-Trent.
tel: +44 (0) 1283 511511 ext 4035
fax: +44 (0) 1283 593064
email: [log in to unmask]
[alternative email for when all too frequently NHS Net isn't working [log in to unmask]]
-----Original Message-----
From: c=GB;a=NHS;p=NHS NATIONAL
INT;dda:RFC-822=LARS.BREIMER(a)Roche.COM;
Sent: 24 October 2001 20:05
To: Reynolds Tim (RJF) Burtonh-tr; c=GB;a=NHS;p=NHS NATIONAL
INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
Subject: RE: Fasting lipid profile in diabetics -- is it efficient
practic e?
1] Does anyone know how frequent pancreatitis is with at non-fasting TG = 20 is? Or, is the risk of pancreatitis with high TG exaggerated?
2] What is the current coctail for a diabetic? apart from antihyperglycaemic therapy, should they be on clopidgrel, a statin or fibrate, some sort of anti-angiotensin inhibition, Xenical and sildenafil? Seriously, could we practice more efficiently by not doing full lipid profiles in diabetics and rely on cholesterol for which fasting is not necessary, for example after eight weeks on a statin?
Kind regards
Lars
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]
Sent: 24 October 2001 14:29
To: [log in to unmask]
Subject: Re: Fasting lipid profile in diabetics
It is ideal but I am quite happy to do profile on anyone no matter what their fasting status is. IF the result indicates mild increases it is then essential to do a fasting lipid but if for example the non-fasting trig is 20, fasting won't bring that to within the reference range so treatment is almost certainly necessary.
TIM
**************************************************************************
Prof. Tim Reynolds,
Clinical chemistry Dept.,
Queen's Hospital,
Belvedere Rd.,
Burton-on-Trent.
tel: +44 (0) 1283 511511 ext 4035
fax: +44 (0) 1283 593064
email: [log in to unmask]
[alternative email for when all too frequently NHS Net isn't working [log in to unmask]]
-----Original Message-----
From: c=GB;a=NHS;p=NHS NATIONAL
INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
Sent: 24 October 2001 16:13
To: c=GB;a=NHS;p=NHS NATIONAL
INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
Subject: Fasting lipid profile in diabetics
Dear list members
would people insist on 12 hours fasting for performing
lipid profile (total cholesterol, triglyceride and
HDL)in diabetic patients?
thanks
Mohammad
=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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